UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
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FORM 10-K
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[X]
ANNUAL REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended
December 31, 2017
[ ]
TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the transition period from ____________ to ____________
COMMISSION FILE NUMBER 001-35811
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Health Insurance Innovations, Inc.
(Exact name of registrant as specified in its charter)
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Delaware
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46-1282634
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(State or other jurisdiction of
incorporation or organization)
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(IRS Employer
Identification No.)
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15438 North Florida Avenue, Suite 201
Tampa, Florida 33613
(Address of principal executive offices) (zip code)
Registrant’s telephone number, including area code:
(813) 397-1187
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SECURITIES REGISTERED PURSUANT TO SECTION 12(b) OF THE ACT:
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Title of each class
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Name of each exchange on which registered
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Class A common stock, par value $0.001 per share
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NASDAQ Global Market
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SECURITIES REGISTERED PURSUANT TO SECTION 12(g) OF THE ACT: None
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Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes [ ] No [X]
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or Section 15(d) of the Exchange Act.
Yes [ ] No [X]
Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the Registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.
Yes [X] No [ ]
Indicate by check mark whether the registrant has submitted electronically and posted on its corporate Web site, if any, every Interactive Data File required to be submitted and posted pursuant to Rule 405 of Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit and post such files).
Yes [X] No [ ]
Indicate by check mark if disclosure of delinquent filers pursuant to Item 405 of Regulation S-K (§229.405 of this chapter) is not contained herein, and will not be contained, to the best of registrant’s knowledge, in definitive proxy or information statements incorporated by reference in Part III of this Form 10-K or any amendment to this Form 10-K. [ ]
Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and "emerging growth company," in Rule 12b-2 of the Exchange Act.
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Large accelerated filer
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Emerging growth company
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[X]
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Accelerated filer
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[X]
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Non-accelerated filer
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[ ]
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(Do not check if a smaller reporting company)
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Smaller reporting company
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[X]
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If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. [ ]
Indicate by check mark whether the registrant is a shell company (as defined in Exchange Act Rule 12b-2). Yes [ ] No [X]
The aggregate market value of the registrant’s Class A and Class B common stock held by non-affiliates of the registrant, as of June 30, 2017, was approximately $271.2 million. Such aggregate market value was computed by reference to the closing price of the Class A common stock as reported on the NASDAQ Global Market on June 30, 2017.
As of
February 26, 2018
, there were
12,731,758
shares of the registrant’s Class A common stock, $0.001 par value per share, outstanding and
3,841,667
shares of the registrant’s Class B common stock, $0.001 par value per share, outstanding.
DOCUMENTS INCORPORATED BY REFERENCE
Portions of the definitive proxy statement for the 2018 Annual Meeting of Stockholders of the Registrant to be filed subsequently with the SEC are incorporated by reference into Part III of this Annual Report on Form 10-K to the extent indicated herein.
EXPLANATORY NOTE
The registrant meets the “accelerated filer” requirements as of the end of its 2017 fiscal year pursuant to Rule 12b-2 of the Securities Exchange Act of 1934, as amended. However, pursuant to Rule 12b-2 and SEC Release No. 33-8876, the registrant (as a smaller reporting company transitioning to the larger reporting company system based on its public float as of June 30, 2017) is not required to satisfy the larger reporting company requirements until its first quarterly report on Form 10-Q for the 2018 fiscal year and thus remains eligible to use the scaled disclosure requirements applicable to smaller reporting companies under Item 10 of Regulation S-K under the Securities Act of 1933, as amended, in this Annual Report on Form 10-K.
TABLE OF CONTENTS
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ITEM 1.
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ITEM 1A.
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ITEM 1B.
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ITEM 2.
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ITEM 3.
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ITEM 4.
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ITEM 5
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ITEM 6.
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ITEM 7.
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ITEM 7A.
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ITEM 8.
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ITEM 9.
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ITEM 9A.
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ITEM 9B.
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ITEM 10.
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ITEM 11.
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ITEM 12.
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ITEM 13.
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ITEM 14.
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ITEM 15.
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INTRODUCTION
Health Insurance Innovations, Inc. is a Delaware corporation incorporated on October 26, 2012. In this annual report, unless the context suggests otherwise, references to the “Company,” “we,” “us” and “our” refer (1) prior to the February 13, 2013 closing of an initial public offering (“IPO”) of the Class A common stock of Health Insurance Innovations, Inc. and related transactions, to Health Plan Intermediaries, LLC (“HPI”) and Health Plan Intermediaries Sub, LLC (“HPIS”), its consolidated subsidiary, and (2) after the IPO and related transactions, to Health Insurance Innovations, Inc. and its consolidated subsidiaries. The terms “HIIQ” and “HPIH” refer to the stand-alone entities Health Insurance Innovations, Inc., and Health Plan Intermediaries Holdings, LLC, respectively. The terms “HealthPocket” or “HP” refer to HealthPocket, Inc., our wholly owned subsidiary which was acquired by HPIH on July 14, 2014. The term “ASIA” refers to American Service Insurance Agency LLC, a wholly owned subsidiary which was acquired by HPIH on August 8, 2014. HPIH, HP and ASIA are consolidated subsidiaries of HIIQ.
SPECIAL NOTE REGARDING FORWARD-LOOKING STATEMENTS
We have made statements in “Item 1. Business,” “Item 1A. Risk Factors,” “Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations,” and in other sections of this report that are forward-looking statements. All statements other than statements of historical fact included in this report are forward-looking statements. You can identify forward-looking statements by the fact that they do not relate strictly to historical or current facts. These statements may include words such as “may,” “might,” “will,” “should,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “predicts,” “potential” or “continue,” the negative of these terms and other comparable terminology. These forward-looking statements, which are subject to risks, uncertainties and assumptions about us, may include projections of our future financial performance, our anticipated growth strategies, anticipated trends in our business and other future events or circumstances. These statements are only predictions based on our current expectations and projections about future events. There are important factors that could cause our actual results, level of activity, performance or achievements and other future events or circumstances to differ materially from the results, level of activity, performance or achievements, events or circumstances expressed or implied by the forward-looking statements, including those factors discussed “Item 1A. Risk Factors.”
We cannot guarantee future results, level of activity, performance, achievements, events or circumstances. We are under no duty to update any of these forward-looking statements after the date of this report to conform our prior statements to actual results or revised expectations.
PART I
ITEM 1. BUSINESS
Overview
We are a cloud-based technology platform and distributor of affordable individual and family health insurance plans (“IFP”) which include short-term medical (“STM”) insurance plans, and guaranteed-issue and underwritten health benefit insurance plans ("HBIP"), previously referred to as hospital indemnity plans. Through our technology platform, we also offer supplemental products which include a variety of additional insurance and non-insurance products that are frequently purchased as supplements to IFPs. We work in concert with carriers to help them develop products for our target markets. We are not an insurer and do not process or pay claims. The health insurance products we help develop are underwritten by third-party insurance carriers with whom we have no affiliation apart from our contractual relationships. We assume no underwriting, insurance or reimbursement risk.
We help design and structure IFPs and supplemental products in concert with insurance carriers and discount benefit providers. We market products to individuals through our internal distribution network, and we also use an external distribution network consisting of independently owned and operated licensed-agent call centers to market to individuals. For both our internal distribution network and our external distribution network, we collect money and manage the member's non-claims related experience for the IFPs and supplemental products.
STM plans feature a streamlined underwriting process offering immediate coverage options. STM plans generally offer qualifying individuals insurance benefits for fixed short-term durations. STM plans provide up to three months of health insurance coverage with a wide range of deductible and copay levels. In 2016, the Internal Revenue Service, the Employee Benefits Security Administration, and the U.S Department of Health and Human Services, collectively “HHS,” published Internal Revenue Bulletin 2016-47, which provided that, effective January 1, 2017, all STM plans submitted before April 1, 2017 must terminate no later than December 31, 2017, and effective April 1, 2017, new limits were set on STM duration to periods of less than three months but allowing for re-applications with the same or different health insurance carrier.
On February 20, 2018, the Departments of Health and Human Services, Labor, and Treasury, proposed a new rule that would change the way that short-term, limited duration insurance coverage (or short-term plans) is regulated. The proposed rule was developed in response to President Trump's executive order from October 2017 that directed the federal government to expand access to short-term plans, association health plans, and health reimbursement arrangements.
The new rule would extend the maximum duration of these plans from three months to "less than 12 months" (which could be as long as 364 days). The new rule also includes updated notice requirements. The proposed rule specifies that these new requirements would go into effect 60 days after publication of the final rule in the Federal Register. Comments from stakeholders regarding the proposed rule will be accepted until late April 2018. The Departments of Health and Human Services, Labor, and Treasury, will then need to consider these comments, draft a final rule, undergo inter-agency review, and then obtain approval by the Office for Management and Budget before releasing the final rule.
HBIPs are insurance products which include both guaranteed-issue and underwritten plans that pay fixed cash benefits, and additional benefits for certain plans, for covered procedures and services for individuals under the age of 65. These highly customizable products are generally on an open-provider network without copayments or deductibles and do not have defined policy term lengths.
We provide numerous low-cost supplemental insurance and discount benefit products, including pharmacy benefit cards, dental plans, vision plans, cancer/critical illness plans, deductible and gap protection plans, and life insurance policies that are frequently purchased as supplements to IFPs. These are typically monthly programs with automatic renewal that are not affected by the changes to rules relating to the maximum duration or renewal of STM products.
We manage member relations via email, through our online member portal, which is available 24 hours a day, seven days a week, and via telephone. Our online enrollment process allows us to aggregate and analyze consumer data and purchasing habits to track market trends and drive product innovation.
Our scalable, proprietary, and web-based technology platform provides members immediate access to the products we sell through our internal and third-party distribution channels. Members can tailor product selections to meet their personal insurance and budget needs, buy policies and print policy documents and identification cards in real-time. Our technology platform uses abbreviated online applications, some with health questionnaires, to provide an immediate "accept or reject" decision using rules and criteria determined by the carriers for the products we offer. Once an application is accepted, individuals can use our automated
payment system to complete the enrollment process and obtain instant electronic access to their policy fulfillment documents, including the insurance policy, benefits schedule and identification cards. We receive credit card and Automated Clearing House (“ACH”) payments directly from members at the time of sale. Our technology platform provides scalability and, on a per-policy-basis, reduces the costs associated with marketing, selling, and administering policies.
Our sales of IFP and supplemental products focus on the under-penetrated segment of the U.S. population who are uninsured or underinsured. These respective classes include individuals not covered by employer-sponsored insurance plans, such as the self-employed, small business owners and their employees, individuals who are unable to afford the rising cost of IMM premiums, underserved “gap populations” that require insurance due to changes caused by life events, such as new graduates, divorcees, early retirees, military discharges, the unemployed, part-time and seasonal employees and potential members seeking health insurance between the open enrollment periods created under the Patient Protection and Affordable Care Act (“PPACA”).
As the managing general underwriter and/or broker of IFP and supplemental products, we receive all amounts due in connection with the plans we sell and administer on behalf of the service providers. We refer to these total collections as "premium equivalents," which typically represent a combination of premiums, fees for discount benefit plans, enrollment fees, and third-party commissions and referral fees. From premium equivalents, we remit risk premiums to carriers and amounts earned by discount benefit plan providers, who we refer to as third-party obligors, as such carriers and third-party obligors are the ultimate parties responsible for providing the insurance coverage or discount benefits to the member. Our revenues consist of the net balance of the premium equivalents.
We collect premium equivalents upon the initial sale of the plan and then monthly upon each subsequent periodic payment under such plan. We receive most premium equivalents through online credit card or ACH processing. As a result, we have limited accounts receivable. We generally remit the risk premium to the applicable carriers and the amounts earned by third-party obligors on a monthly basis based on their respective compensation arrangements.
We also provide consumers with access to health insurance information search and comparison technology through our website, HealthPocket.com. This website allows consumers to easily and clearly compare and rank health insurance plans available for an individual, family or small business, empowering consumers to make health plan decisions and reduce their out-of-pocket costs.
In 2015, we launched a direct-to-consumer insurance website that allows consumers to research health insurance trends, comparison shop, and purchase IFP under the AgileHealthInsurance® brand. AgileHealthInsurance.com (“Agile”) is one of the few internet sites dedicated to helping consumers understand the benefits of Term Health Insurance and HBIP. We use the term “Term Health Insurance” to refer to fixed-term health insurance products of less than one year in duration, such as STM plans. These IFP plans are the culmination of extensive research on health insurance needs in the PPACA era, and we believe consumers will be able to find affordable prices for these plans on Agile. Agile utilizes what we believe is a best-in-class plan comparison and online enrollment tool for STM and HBIP.
Health Insurance Industry and Market Opportunity
In recent years there have been major proposed changes to health insurance laws. Some of these proposals were implemented under PPACA and the Health Care and Education Reconciliation Act of 2010 (“HCERA”), which we collectively refer to as “Healthcare Reform.” These reforms imposed requirements on a broad segment of the population, including a mandate that most individuals carry health insurance or face tax penalties (the “Individual Mandate Penalty”); tax credits and subsidies for the policy premium costs of IMM plans for qualifying individuals; the establishment of a mandatory set of ten Essential Health Benefits for IMM plans; a mandate that certain employers offer most of their employees group health insurance coverage or face tax penalties; prohibitions against insurance companies that offer IMM insurance plans using pre-existing health conditions as a reason to deny an application for health insurance; and medical loss ratio (“MLR”) requirements that require each health insurance carrier to spend a certain percentage of its IMM premium revenue on reimbursement for clinical services and activities that improve healthcare quality. Among other things, these changes resulted in a dramatic increase in the unsubsidized average premium for IMM plans as compared to the pre-reform IMM market. We benefit from the exemption of STM (i.e., those with durations less than three months) from the MLR requirements and pre-existing condition prohibitions but are disadvantaged by the tax penalties, to which those insured under STM plans remain subject through December 31, 2018.
The implementation of Healthcare Reform has, among other things, increased the average premium for IMM plans, caused carriers to narrow networks under IMM plans and restricted the availability (except in limited circumstances) to open enrollment periods. Our IFP plans’ affordable premium prices, wide acceptance among healthcare providers and year-round availability provide consumer value not available under PPACA health plans. In addition, Healthcare Reform mandates MLR thresholds that require that IMM carriers use 80% to 85% of all premiums collected to pay claims. This has significantly reduced agent commission
rates on IMM policies, forcing many agents to abandon the traditional face-to-face IMM sales model. Since 2014, IMM carriers are also subject to a pre-existing condition mandate requiring them to accept all members regardless of their pre-existing conditions and to cover all ten Essential Health Benefits. These required coverages further increases the cost of IMM coverage. Unlike IMM plans, our IFP products are not subject to narrow networks and are exempt from the minimum MLR thresholds, “must-carry” pre-existing conditions requirements, and Essential Health Benefits requirements under Healthcare Reform, allowing us to offer more attractive commission rates to our distributors while providing products with average premium cost significantly more affordable than unsubsidized PPACA health plans. We believe these dynamics in the health insurance industry present an opportunity to increase our market share in the individual health insurance market.
In addition, Healthcare Reform also required the establishment of health insurance exchanges (“Exchanges”) where individuals can select and purchase health insurance plans. We believe that our STM products are an attractive option to non-subsidized on- and off- Exchange health insurance policies.
Since the 2016 Presidential election, there have been several changes made to Health Insurance laws and regulations. President Trump signed Executive Order 13765, an “Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal”, on January 20, 2017 (the “Executive Order”), which includes a requirement for Insurance Commissioners and others to “encourage the development of a free and open market in interstate commerce for the offering of healthcare services and health insurance, with the goal of achieving and preserving maximum options for patients and consumers.” Following the issuance of this Executive Order, for the 2017 filing season, the IRS did not require filers to indicate whether they had PPACA compliant health insurance coverage; however, the IRS reversed its position for the 2018 filing season, and has stated that it will not accept any electronically filed tax returns for fiscal year 2017 where the taxpayer does not report full-year health insurance coverage, claim a coverage exemption, or report a shared responsibility payment. Additional reforms to PPACA were implemented under the Tax Cut and Jobs Act of 2017 (“Tax Act”) passed on December 22, 2017. Among other changes under the Tax Act, beginning in 2019, the government will no longer attempt to collect any Individual Mandate Penalty from individuals and families who do not obtain health insurance coverage, although the Healthcare Reform requirement for individuals to carry health insurance remains in effect.
These ongoing changes in the health insurance industry have expanded and reshaped our target market and we believe the market will continue to evolve. We intend to pursue opportunities to help meet consumers’ needs for affordable health insurance. We believe that our technology platform, product focus and industry expertise will allow us to gain an increasing share of this growing market.
Our Strategy
Our objective is to continue to expand our business and increase our presence in the affordable, web-based health insurance solutions market. Our principal strategies to meet this objective are:
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Drive Continuous Product Innovation
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We constantly strive to diversify our product portfolio to provide consumers with more choices for their health insurance needs. In addition to our long-standing relationships with insurance carriers, we continue to develop relationships with new carriers to improve and increase our product mix to help consumers find the right insurance coverage at the right price points while providing new revenue streams to the Company. The expected changes to PPACA are likely to lead to additional opportunities for consumers to obtain health insurance coverage better suited to their needs.
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Enhance the Consumer Experience
. We have invested significant resources and strive to be market leaders in our member service and compliance areas, utilizing new technology and additional personnel.
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Online sales experience via AgileHealthInsurance.com
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In 2015, we launched a direct-to-consumer insurance website that allows consumers to research health insurance trends, comparison shop, and purchase IFP under the AgileHealthInsurance
®
brand. AgileHealthInsurance.com is one of the few internet sites dedicated to helping consumers understand the benefits of Term Health Insurance. We will continue to expand our direct to consumer web presence with continued focus on its profitability.
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Strengthen and Grow Traditional Distribution Channels
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The extensive traditional distribution network we access includes independently owned and operated licensed-agent call centers to sell insurance products. We offer a compensation structure to our distributors that we believe motivates distributors to work with us. By continuing to offer highly competitive commission rates and advance commission arrangements, we believe we will continue to attract new distributors as the insurance marketplace continues to evolve, and we intend to continue to grow our relationships with traditional distributors.
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Strategic acquisitions and other transactions.
We may acquire, or invest in, companies, products or technologies that complement our current products, enhance our market coverage, technical capabilities or production capacity, or offer growth opportunities.
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Our Competitive Strengths
Proprietary, Web-Based, Direct-to-Consumer Technology Platforms
Since we began operations in 2008, we have invested significant financial and human resources in building a unique and scalable proprietary, web-based technology platform. Our technology represents a distinct competitive advantage as it reduces the need for customer care agents, the time associated with quoting, billing, underwriting, fulfillment, sale and marketing and provides significant operating leverage as we add members and product offerings. We have acquired the intellectual property rights to certain software-based technologies as further explained below.
Automated Real-Time Integrated E System (“A.R.I.E.S.”)
A.R.I.E.S. is our proprietary product, distribution, and customer management platform. We believe A.R.I.E.S represents a distinct competitive advantage as it reduces the need for customer care agents and provides significant operating leverage as we add members and product offerings. The A.R.I.E.S. platform processes and combines data that is used in insurance plan and product design, sales and distribution of our products and product bundles, member services, business and regulatory compliance, and general reporting. Key elements of A.R.I.E.S. include:
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Quote-Buy-Print.
Individuals access our technology platform through our distributors and can quote products and buy and print their policy documents and identification cards anytime, anyplace.
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Automated Underwriting.
The entire underwriting process is handled by A.R.I.E.S. through the use of health questionnaires approved by the insurance carriers. Because our IFP products are largely targeted to individuals who do not have significant pre-existing conditions and our HBIP are guaranteed-issue, we do not have a traditional underwriting department. Underwriting for IFP products is an immediate accept or reject decision based on a prospective member’s answers to an abbreviated online health-related questionnaire.
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Multiple Value-Added Products.
Consumers are able to complement our IFP offerings with supplemental products such as pharmacy benefit cards, dental plans, vision plans and cancer/critical illness plans. Our technology platform makes it possible for us to instantly offer these bundled products to fit member needs.
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Turn-Key Solution.
Our technology platform is a turnkey solution, allowing distributors to tailor their offering to meet member needs and can be customized to enhance the experience of an affinity group or employer.
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Payment.
Through our online platform, we receive credit card and ACH payments directly from members at the time of sale and automatically process recurring payments.
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Member Services.
Members have the ability to log-in and change payment information and print new identification cards, all without the need of a customer service representative.
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Verification and Compliance.
We have incorporated eSign technology from Adobe Sign, part of Adobe Inc., on our platform to streamline compliance by providing real-time verification to our members’ mobile devices. This technology has allowed us to further automate our compliance program, enhancing quality while minimizing overhead.
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Integration with AgileHealthInsurance
®
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Our A.R.I.E.S. platform integrates directly with our direct to consumer AgileHealthInsurance.com platform.
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Established Long-Standing Insurance Carrier Relationships
One of our core strengths is long-standing relationships with some of the leading insurance carriers in the United States. This enables us to offer a broad range of IFP and supplemental products on our technology platform. We have entered into written contracts with each of these carriers pursuant to which we sell the carriers’ health plans and supplemental products in exchange for the payment of commissions that vary by carrier and by plan. These contracts are typically non-exclusive and terminable by either party on notice or at the expiration of the term.
Our management team has developed close relationships with the senior management teams of many of our insurance carriers. We believe that the nature of our relationships with our insurance carriers, combined with our product knowledge and technology platform, allow us to provide value-added products to our members. Our relationships with highly rated insurance carriers include Federal Insurance Company ("CHUBB"), AXIS Insurance Company, Everest Reinsurance Company, Standard Life and Accident Insurance Company, and Nationwide Mutual Insurance among others. We also continue to develop relationships with new carriers to help us expand our product portfolio.
Long-Term Relationships with Licensed Insurance Distributors
Our product expertise, our relationships with multiple insurance carriers, our focus on compliance, and our scalable technology platforms make us a partner of choice for our distributors. We have extensive knowledge of the individual health insurance products that we help design and fulfill, which allows us to assist our distributors in placing business. Our management team has built a broad distribution network and continuously adds new third-party licensed independent distributors.
Seasoned Management Team
Our management team has substantial experience and long-standing relationships developed over long periods in the insurance and online insurance marketing industries. Our management team draws on its broad industry experience to identify opportunities to expand our business and collaborate with insurance carriers and distributors to help develop products and respond to market trends.
Our Product Offerings
Our differentiated product offerings allow us to build leading positions in our target markets for insurance and related products. The key products we provide include:
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Short-Term Medical Plans.
STM plans provide up to three months of health insurance coverage with a wide range of deductible and copay levels. In 2016, HHS published Internal Revenue Bulletin 2016-47, which provided that, effective January 1, 2017, all STM plans submitted before April 1, 2017 must terminate no later than December 31, 2017, and effective April 1, 2017, new limits are set on STM duration to periods of less than three months but allowing for re-applications with the same or different health insurance carrier.
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Because the STM plans we offer do not cover pre-existing and often chronic health conditions, and since STM plans have a limited duration, these policies have been designed with generally lower member premiums as compared to IMM insurance.
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Health Benefit Insurance Plans
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Our HBIP typically provide individuals with a daily cash benefit for hospital treatment and doctor office visits as well as accidental injury and death or dismemberment benefits.
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Supplemental Products
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We provide numerous supplemental insurance and discount benefit products, including pharmacy benefit cards, dental plans, vision plans and cancer/critical illness plans, deductible and gap protection plans, and life insurance policies that are frequently purchased as supplements to IFP.
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Sales and Marketing
Our sales and marketing initiatives primarily consist of hiring experienced sales professionals to strengthen our relationships with existing and potential third-party distributors, implementing marketing campaigns, attending industry-sponsored events, and direct-to-consumer via the internet. We utilize our owned call center and independent third-party distributors and independent brokers to market our products to potential members.
We derive a significant portion of our AgileHealthInsurance
®
website traffic through contractual marketing relationships with online businesses. These marketing relationships include online advertisers, content providers and insurance lead aggregators. We also attract website traffic from consumers who search for health insurance through internet search engines. A critical factor in attracting consumers to our website is whether we are prominently displayed in response to internet searches broadly relating to health insurance topics. As part of this marketing strategy, we employ both algorithmic listings and paid advertisements to attract consumers to our website.
Seasonality
The marketing of IFP and supplemental plans is subject to seasonal fluctuations that we believe have been largely impacted by Healthcare Reform. Beginning in 2013, under Healthcare Reform, open enrollment periods were created. During these periods, individuals can enroll in individual insurance programs. During the times that these open enrollment periods are closed, we have the capability to sell our IFP products as health insurance to consumers who are ineligible for plans under PPACA. During the five open enrollment periods to date, we experienced significant fluctuations in sales. Other seasonality trends may develop and the existing seasonality and consumer behavior that we have experienced to date may change as legislative changes to Healthcare Reform continue and our markets change.
Competition
The market for selling insurance products is highly competitive and the sale of health insurance over the internet is rapidly evolving. We compete with individuals and entities that offer and sell health insurance products utilizing traditional distribution channels, as well as the internet. Our current and potential competitors include:
Traditional local insurance agents
. There are thousands of local insurance agents across the United States who sell health insurance products in their communities. We believe that the vast majority of these local agents offer health insurance without significantly utilizing the internet or technology other than simple desktop applications such as word processing and spreadsheet programs. Some traditional insurance agents, however, utilize general agents that offer online quoting services and other tools to obtain quotes from multiple carriers and prepare electronic benefit proposals to share with their potential members. These general agents typically offer their services only for the small and mid-sized group markets (not the individual and family markets) and operate in only a limited geographic region. Additionally, some local agents use the internet to acquire new consumer referrals from companies that have expertise in internet marketing. These “lead aggregator” companies utilize keyword search, primarily paid keyword search listings on various online search engines and other forms of internet advertising, to drive internet traffic to the lead aggregator’s website. The lead aggregator then collects and sells consumer information to agents and, to a lesser extent, to carriers, both of whom endeavor to close the referrals through traditional offline sales methods.
Health insurance carriers’ “direct-to-member” sales
. Some carriers directly market and sell their plans and products to consumers through call centers and their own websites. Although we offer health insurance plans and products for many of these carriers, they also can compete with us by offering their products directly to consumers. Most of these carriers have brand recognition, extensive marketing budgets and significant financial resources to influence consumer preferences for searching and buying health insurance online.
Online agents
. There are a number of agents that operate websites and provide a limited online shopping experience for consumers interested in purchasing health insurance (e.g., online quoting of health insurance product prices). Some online agents also sell non-health insurance products such as auto insurance, life insurance and home insurance.
Exchanges
. Government and privately-administered Exchanges have been established under Healthcare Reform where individuals can select and purchase health insurance plans.
National insurance brokers.
Although insurance brokers have traditionally not focused on the affordable IFP market, they may enter our markets and could compete with us. These large agencies have existing relationships with many of our carrier companies, are licensed nationwide and have large customer bases and significant financial, technical and marketing resources to compete in our markets. Some of these large agencies and financial services companies have worked with us in order to offer our services to their customer and member bases.
We believe the principal factors that determine our competitive advantage in the online distribution of health insurance include the following:
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affordable, value added healthcare, supplemental, and related products;
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proprietary, web-based technology platform;
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strength of carrier relationships and depth of technology integration with carriers;
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data-driven product design;
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highly automated compliance program;
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strength of distribution relationships; and
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proven capabilities measured in years of delivering sales and creating and using reliable technology.
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Intellectual Property
Our success depends, in part, on our ability to protect our intellectual property and proprietary technology, and to operate our business without infringing or violating the intellectual property or proprietary rights of others. We rely on a combination of copyrights, trademarks, domain names, trade secrets, intellectual property licenses and other contractual rights (including confidentiality and non-disclosure agreements), including our proprietary technology. However, these intellectual property rights may not prevent others from creating a competitive online platform or otherwise competing with us.
For more information see Item 1A. Risk Factors—“We rely on third-party vendors to develop, host, maintain, service and enhance our technology platform” and Item 1A. Risk Factors—“Our failure to obtain, maintain and enforce the intellectual property rights on which our business depends could have a material adverse effect on our business, financial condition and results of operations.”
Healthcare Laws and Regulations
Our business is subject to extensive, complex and rapidly changing federal and state laws and regulations. Various federal and state agencies have discretion to issue regulations and interpret and enforce healthcare laws. While we believe we comply in all material respects with applicable healthcare laws and regulations, these regulations can vary significantly from jurisdiction to jurisdiction, and interpretation of existing laws and regulations may change. Federal and state legislatures also may enact various legislative proposals that could materially impact certain aspects of our business. The following are summaries of key federal and state laws and regulations that impact our operations:
Healthcare Reform
In March 2010, Healthcare Reform was signed into law. Healthcare Reform contains provisions that have changed and will continue to change the health insurance industry in substantial ways. For example, Healthcare Reform includes a mandate requiring individuals to be insured or face tax penalties; a mandate that employers with over 50 employees offer their employees group health insurance coverage or face tax penalties; prohibitions against insurance companies that offer IMM plans using pre-existing health conditions as a reason to deny an application for health insurance; MLR requirements that require each health insurance carrier to spend a certain percentage of their premium revenue on reimbursement for clinical services and activities that improve healthcare quality; establishment of Exchanges to facilitate access to, and the purchase of, health insurance; and subsidies and cost-sharing credits to make health insurance more affordable for those below certain income levels.
Healthcare Reform amended various provisions in many federal laws, including the Internal Revenue Code, the Employee Retirement Income Security Act of 1974 and the Public Health Services Act. Healthcare Reform is being implemented by the Department of Health and Human Services, the Department of Labor and the Department of Treasury. Many of the PPACA regulations became effective on or before January 1, 2014. Through these regulations, the federal government and its implementing agencies may regulate or otherwise impose restrictions upon all types of health insurance including the IFP products that we sell. Although the Supreme Court of the United States upheld Healthcare Reform’s mandate requiring individuals to purchase health insurance in 2012, the Tax Act has eliminated the Individual Mandate Penalty for individuals who do not purchase such health insurance beginning in 2019, and there is additional uncertainty about whether other parts of Healthcare Reform or PPACA regulations will remain in effect or be further amended, with the possibility of future litigation with respect to certain provisions as well as legislative efforts to repeal and defund portions of Healthcare Reform or Healthcare Reform in its entirety. We cannot predict the outcome of any future legislation or litigation related to Healthcare Reform. As described under “Item 1. Business—Health Insurance Industry and Market Opportunity,” Healthcare Reform has resulted in profound changes to the individual health insurance market and our business, and we expect these changes to continue.
Internal Revenue Bulletin: 2016-47
On June 10, 2016, the Internal Revenue Service, the Employee Benefits Security Administration, and the U.S Department of Health and Human Services, collectively “HHS,” proposed rule 2016-13583, that impacts STM insurance. On October 31, 2016, HHS published the rule substantially as proposed despite opposition from significant stakeholders during the open comment period. The rule limits STM duration to periods of less than three months but allows for re-applications with the same or different health insurance carrier. The rule also requires notification of non-compliance with the minimum essential coverage standards set forth in the Affordable Care Act. The rule went into effect on January 1, 2017. On October 12, 2017, President Trump signed an Executive Order promoting healthcare choice and competition across the United States which calls for expanded availability of short-term, limited-duration insurance, such as STM, to consider allowing such insurance to cover longer periods and be renewed by the consumer.
Anti-Kickback Laws
In the United States, there are federal and state anti-kickback laws that generally prohibit the payment or receipt of kickbacks, bribes or other remuneration given with the intent to induce the referral of patients or other health-care program related business. The federal Anti-Kickback Statute makes it unlawful for individuals or entities to knowingly and willfully offer, pay, solicit, or receive any remuneration, directly or indirectly, to induce or reward referrals of items or services reimbursable by a federal healthcare program. Where remuneration is paid purposefully to induce or reward referrals of items or services payable by a federal healthcare program, the Anti-Kickback Statue is violated. For purposes of the Anti-Kickback Statute, “remuneration” includes the transfer of anything of value, directly or indirectly, overtly or covertly, in cash or in kind. There are also state law corollaries to the federal Anti-Kickback Statute. Penalties for violations include criminal penalties and civil sanctions such as fines, imprisonment, and possible exclusion from federal healthcare programs.
Federal Civil False Claims Act and State False Claims Laws
The federal civil False Claims Act imposes liability on any person or entity who, among other things, knowingly presents, or causes to be presented, a false or fraudulent claim for payment by a federal healthcare program. The “qui tam” or “whistleblower” provisions of the False Claims Act allow a private individual to bring actions on behalf of the federal government alleging that the defendant has submitted a false claim to the federal government, and to share in any monetary recovery. There are also state law corollaries to the federal False Claims Act. Our future activities relating to the manner in which we sell and market our services may be subject to scrutiny under these laws.
HIPAA, Privacy Laws and Data Security Regulations
By processing data on behalf of our clients and members, we are subject to specific compliance obligations under privacy and data security-related laws, including the Health Insurance Portability and Accountability Act (“HIPAA”), the Health Information Technology for Economic and Clinical Health Act (the “HITECH Act”), and related state laws. We are also subject to federal and state security breach notification laws, as well as state laws regulating the processing of protected personal information, including laws governing the collection, use and disclosure of social security numbers and related identifiers.
The regulations that implement HIPAA and the HITECH Act establish uniform standards governing the conduct of certain electronic healthcare transactions and protecting the security and privacy of individually identifiable health information maintained or transmitted by healthcare providers, health plans, and healthcare clearinghouses, all of which are referred to as “covered entities,” and their “business associates” (which includeds anyone who performs a service on behalf of a covered entity involving the use or disclosure of protected health information and is not a member of the covered entity’s workforce). Our carrier companies’ and our clients’ health plans generally will be covered entities, and as their business associate, we may asked to contractually comply with certain aspects of these standards by entering into requisite business associate agreements with the covered entities. Under the HIPAA implementing regulations, business associates and covered entities can each be held individually responsible for privacy and data security breaches.
HIPAA Health Care Offense Standards
HIPAA created a class of federal crimes known as the “Federal health care offenses,” including healthcare fraud and false statements relating to healthcare matters. HIPAA prohibits, among other things, executing a scheme to defraud any healthcare benefit program, or concealing a material fact or making a materially false statement in connection with the payment for healthcare benefits, items or services. Entities that are found to have aided or abetted in a violation of HIPAA's Federal health care offense provsions are deemed by statute to have committed the offense and are punishable as a principal.
State Privacy Laws
In addition to federal regulations issued under HIPAA, some states have enacted privacy and security statutes or regulations, or State Privacy Laws, that govern the use and disclosure of a person’s medical information or records and, in some cases, are more stringent than those issued under HIPAA. These State Privacy Laws include regulation of health insurance providers and agents, regulation of organizations that perform certain administrative functions such as utilization review or third-party administration, issuance of notices of privacy practices, and reporting and providing access to law enforcement authorities. In those cases, it may be necessary to modify our operations and procedures to comply with these more stringent State Privacy Laws. If we fail to comply with applicable State Privacy Laws, we could be subject to additional sanctions.
Consumer Protection Laws
Federal and state consumer protection laws are being increasingly enforced by the United States Federal Trade Commission (“FTC”), the Federal Communications Commission (“FCC”), and the various states’ attorneys general to regulate the collection, use, storage and disclosure of personal or patient information, through websites or otherwise, and to regulate the presentation of web site content and to regulate direct marketing, including telemarketing and telephonic communication. Courts may also adopt the standards for fair information practices promulgated by the FTC, concerning consumer notice, choice, security and access.
As part of the payment-related aspects of our business, we may also undertake security-related obligations arising out of the USA Patriot Act, Gramm-Leach-Bliley Act and the Payment Card Industry guidelines applicable to card systems. These requirements generally require safeguards for the protection of personal and other payment related information.
State Insurance Laws
Some of the states in which we operate have laws prohibiting unlicensed persons or business entities, including corporations, from making certain direct and indirect payments or fee-splitting arrangements with licensed insurance agents and brokers. Possible sanctions for violation of these restrictions include loss of license and civil penalties. These statutes vary from state to state, are often vague, and have seldom been interpreted by the courts or regulatory agencies.
State insurance laws also require us to maintain any combination of insurance agency, broker, and third-party administrator licenses in each state in which we transact health insurance business and adhere to sales, documentation and administration practices specific to that state. Where there is any ambiguity or uncertainty in statutes as to whether we require a particular type of license in a state, we seek to obtain that license. In addition, each of our employees who solicits, negotiates, sells or transacts health insurance business for us must maintain an individual insurance agent or broker license in one or more states. Because we transact business in the majority of states, compliance with health insurance-related laws, rules and regulations is difficult and imposes significant costs on our business.
In certain states, some of our products may only be available as a group association plan. In these states members must enroll in group programs or associations in order to access certain of our insurance products, benefits and services. We have entered into relationships with such associations in order to provide individuals access to our products. For example, we have an agreement with Med-Sense Guaranteed Association (“Med-Sense”), a non-profit association that provides membership benefits to individuals and gives members access to certain of our products. Under the agreement, we primarily market membership in the association and collect certain fees and dues on its behalf. In return, we have sole access to its membership list, Med-Sense exclusively endorses the insurance products that we offer and we receive compensation for our services. Our agreement with Med-Sense is automatically renewable for one-year terms, unless terminated on 120 days written notice by either party. The agreement is also terminable on 15 days’ written notice by either party under certain circumstances, such as in the case of a breach.
Employees
As of
December 31, 2017
, we had 199 employees, of which 196 were full-time employees. As of
December 31, 2016
, we had 174 employees, of which 172 were full-time employees. We have not experienced any work stoppages and consider our employee relations to be good. None of our employees are represented by a labor union.
ITEM 1A. RISK FACTORS
In addition to the other information set forth in this report, you should carefully consider the following factors, which could materially affect our business, financial condition or results of operations in future periods. The risks described below are not exhaustive and are not the only risks facing our Company. Additional risks not currently known to us or that we currently deem to be immaterial also may materially adversely affect our business, financial condition or results of operations in future periods.
Risks Relating to Our Business and Industry
Our business practices and the business practices of our third-party licensed distributors and carriers are currently being reviewed by various state insurance regulators and the results of such reviews may adversely affect our business and results of operations.
Our business practices and the business practices of our third-party licensed distributors and carriers are heavily regulated by each state in the United States and various federal agencies. State regulators require that we and our third-party licensed distributors adhere to sales, documentation, and administration practices specific to each state. As a result, we are currently subject to several state regulatory examinations and actions as further described in Note 12 “Commitments and Contingencies” in Part IV, Item 15 of this report. These examinations and actions include a multistate examination being led by the Indiana Department of Insurance and a civil investigative demand from the Massachusetts Attorney General’s Office, as further described in Item 15 of this report. An adverse finding or result in one or more of these matters could result in significant liability, additional state insurance licensing requirements or the revocation of licenses in a particular jurisdiction, which could significantly reduce our revenues, increase our operating expenses, prevent us from transacting health insurance business in a particular jurisdiction and otherwise harm our business, results of operations and financial condition. Moreover, an adverse regulatory action in one jurisdiction could result in penalties and adversely affect our license status or reputation in other jurisdictions due to the requirement that adverse regulatory actions in one jurisdiction be reported to other jurisdictions. Even if the allegations in any regulatory or other action against us are proven false, any surrounding negative publicity could harm member, distributor or health insurance carrier confidence in us, which could significantly damage our reputation
The market for health insurance in the United States is rapidly evolving, which makes it difficult to forecast demand for our products.
The market for health insurance in the United States is rapidly evolving. Accordingly, our future financial performance will depend in part on growth in this market and on our ability to adapt to emerging demands in this market. We believe demand for our products has been driven in large part by regulatory changes, broader use of the internet and advances in technology. It is difficult to predict with any precision the future growth rate and size of our target market. The rapidly evolving nature of the market in which we operate, as well as other factors that are beyond our control, reduce our ability to evaluate accurately our long-term outlook and forecast performance or other operating results. A reduction in demand for our products caused by lack of acceptance, technological challenges, competing offerings or other factors would result in a lower revenue growth rate or decreased revenue, either of which could negatively impact our business and results of operations.
A substantial portion of our business is concentrated in a small number of carriers, and such concentration could make our business more vulnerable to adverse changes in our relationships with carriers.
We typically enter into contractual agency relationships with insurance carriers that are non-exclusive and terminable on notice by either party for any reason. Insurance carriers may be unwilling to underwrite our health insurance plans or products or may amend our agreements with them for a variety of reasons, including for competitive or regulatory reasons. Insurance carriers may decide to rely on their own internal distribution channels, including traditional in-house agents, insurance carrier websites or other sales channels, or to market their own plans or products, and, in turn, could limit or prohibit us from marketing their plans or products. Insurance carriers may decide not to underwrite insurance plans or products in the individual health insurance market in certain geographies or altogether. Our carrier relationship could also be affected by lawsuits and regulatory actions against our carriers relating to the products sold by us, as such carriers may seek indemnification or reimbursement from us or may seek to otherwise adversely change their relationship with us. Carriers can be, and two of our carriers have been, subject to lawsuits and regulatory actions of which we could, and have been, named parties. The termination or amendment of our relationship with an insurance carrier could reduce the variety of health insurance plans or products we offer. We also could lose a source of, or be paid reduced commissions for, future sales. Our business could also be harmed if we fail to develop new insurance carrier relationships or are unable to offer members a wide variety of health insurance plans and products.
The private health insurance industry in the United States has experienced substantial consolidation over the past several years. As a result of this trend, it may become necessary for us to offer insurance plans and products from a reduced number of
insurance carriers or to derive a greater portion of our revenue from a more concentrated number of insurance carriers as our business and the health insurance industry evolve. Each of these insurance carriers may terminate our agreements with them. In addition, one or more of our insurance carriers could experience a failure of its business due to a decline in sales volumes, unavailability of reinsurance, and failure of business strategy or otherwise. Should our dependence on a smaller number of insurance carriers increase, whether as a result of the termination of insurance carrier relationships, further insurance carrier consolidation, business failure, bankruptcy or any other reason, we may become more vulnerable to adverse changes in our relationships with our insurance carriers, particularly in states where we offer health insurance plans and products from a relatively small number of insurance carriers or where a small number of insurance carriers dominate the market. The termination, amendment or consolidation of our relationships with our insurance carriers could harm our business, results of operations and financial condition.
Our business could be harmed if we lose our relationships with independent distributors, fail to maintain good relationships with independent distributors, become dependent upon a limited number of third-party distributors or fail to develop new relationships with third-party distributors.
We depend upon licensed third-party distributors, in addition to our internal distribution network, to sell our products. We typically enter into contractual agency relationships with independent distributors that are non-exclusive and terminable on short notice by either party for any reason. In many cases, these distributors also have the ability to amend the terms of our agreements unilaterally on short notice. Third-party distributors may be unwilling to sell our health insurance plans or products or may amend our agreements with them for a variety of reasons, including for competitive or regulatory reasons. For example, these independent distributors may decide to sell plans and products that bring them a higher commission than our plans and products or may decide not to sell IFP plans at all. Because we rely on a diverse distributor network to sell the products we offer, any loss of relationships with independent distributors or failure to maintain good relationships with independent distributors could harm our business, results of operations and financial condition. We have terminated, and could continue to terminate relationships, with distributors for their failure to follow our compliance standards or their otherwise engaging in problematic business practices.
We depend on relationships with third-parties for certain services that are important to our business. An interruption or cessation of such services by any third-party could have a material adverse effect on our business.
We depend on a number of third-party relationships to enhance our business. For instance, state regulations may require that individuals enroll in group programs or associations in order to access certain insurance products, benefits and services. We have entered into relationships with certain associations in order to provide individuals access to our products. For example, we have an agreement with Med-Sense, a non-profit association that provides membership benefits to individuals and gives members access to certain of our products. Under the agreement, we primarily market membership in the association and collect certain fees and dues on its behalf. In return, we have sole access to its membership list, and Med-Sense exclusively endorses the insurance products that we offer. Members of the association are given access to a wide variety of our products that are otherwise unavailable to non-members. We also have affiliations with other associations offering similar benefits as alternatives to Med-Sense. Med-Sense has the right to cancel its agreement with us at any time by providing 120 days’ prior written notice. While we believe we could replace Med-Sense with other group programs or associations, there can be no assurance that any of our other association affiliations could replace Med-Sense or if we could find another association to replace Med-Sense on a timely basis or at all. If we were to lose our relationship with Med-Sense and were unable to find another group program or association on a timely basis or at all, this would have a material adverse effect on our business.
Our ability to offer our services and operate our business is therefore dependent on maintaining our relationships with third-party partners, particularly Med-Sense, and entering into new relationships to meet the changing needs of our business. Any deterioration in our relationships with such partners, or our failure to enter into agreements with partners in the future could harm our business, results of operations and financial condition. If our partners are unable or unwilling to provide the services necessary to support our business, or if our agreements with such partners are terminated, our operations could be significantly disrupted. We may also incur substantial costs, delays and disruptions to our business in transitioning such services to ourselves or other third-party partners. In addition, third-party partners may not be able to provide the services required in order to meet the changing needs of our business.
We rely on third-party vendors to develop, host, maintain, support and enhance our technology platform
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We are party to agreements with BimSym pursuant to which BimSym provides various professional services relating to our A.R.I.E.S. technology platform, including hosting, support, maintenance and development services. Our ability to offer our services and operate our business is therefore dependent on maintaining our relationships with third-party vendors, particularly BimSym, and entering into new relationships to meet the changing needs of our business. Any deterioration in our relationships with such vendors, or our failure to enter into agreements with vendors in the future could harm our business, results of operations and financial condition. If our vendors are unable or unwilling to provide the services necessary to support our business, or if our agreements with such vendors are terminated, our operations could be significantly disrupted. We may also incur substantial costs, delays and disruptions to our business in transitioning such services to ourselves or other third-party vendors. In addition, third-party vendors may not be able to provide the services required in order to meet the changing needs of our business.
Insurance carriers could reduce the commissions paid to us or change their plan pricing practices in ways that reduce the commissions paid to us, which could harm our revenue and results of operations.
Our commission rates are negotiated between us and each insurance carrier. Insurance carriers have altered, and may in the future alter, the contractual relationships we have with them, either by renegotiation or unilateral action. Also, insurance carriers may adjust their commission. If these contractual changes result in reduced commissions, our revenue may decline.
In addition, insurance carriers periodically adjust the premiums they charge to individuals for their insurance policies. These premium changes may cause members to cancel their existing policies and purchase a replacement policy from a different insurance carrier, either through our platform or through another administrator. We may receive a reduced commission or no commission at all when a member purchases a replacement policy. Also, because insurance rates may vary between insurance carriers, plans and enrollment dates, changes in our enrollment mix may impact our commission revenue. Future changes in insurance carrier pricing practices could harm our business, results of operations and financial condition.
We face intense competition and compete with a broad range of market participants within the health insurance industry. If competition increases, our growth and profits may decline.
The market for selling individual health insurance and supplemental products is highly competitive and, except for regulatory considerations, there are limited barriers to entry. Currently, we believe the cost-effective, high-quality IFP solutions that we distribute to the individual health insurance market are, in most cases, differentiated from our competitors. Because the barriers to entry in our markets are not substantial and competitors have the flexibility to select new health insurance carriers, we believe that the addition of new competitors, or the adoption of our business model by existing competitors, could occur relatively quickly.
We compete with entities and individuals that offer and sell products similar to ours utilizing traditional distribution channels, including insurance agents and brokers across the United States who sell health insurance products in their communities. In addition, many insurance carriers directly market and sell their plans and products to individuals through call centers and their own websites. The Exchanges created under Healthcare Reform represent another means of distribution for IMM policies and are currently receiving substantial publicity and advertising.
Although we offer health insurance plans and products for many insurance carriers, they also compete with us by offering their plans and products directly to individuals or may elect to compete with us by offering their plans and products directly to individuals in the future. We may not be able to compete successfully against our current or future competitors. Some of our current and potential competitors have longer operating histories in the health insurance industry, access to larger customer bases, greater name recognition and significantly greater financial, technical, marketing and other resources than we do. As compared to us, our current and future competitors may be able to:
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undertake more extensive marketing campaigns for their brands and services;
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devote more resources to website and systems development;
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negotiate more favorable commission rates; and
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attract potential employees, marketing partners and third-party service providers.
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Further, there are many alternatives to the individual health insurance products that we currently provide. We can make no assurances that we will be able to compete effectively with the various individual health insurance products that are currently available or may become available in the future. Competitive and regulatory pressures may result in our experiencing increased
marketing and other costs and loss of market share, or may otherwise harm our business, results of operations and financial condition.
Changes and developments in the health insurance system in the United States, in particular the implementation of Healthcare Reform, could harm our business.
Our business depends upon the private sector of the U.S. insurance system, its role in financing healthcare delivery, and insurance carriers’ use of, and payment of commissions to, agents, brokers and other organizations to market and sell health insurance plans and products.
Healthcare Reform contains provisions that have changed and will continue to change the industry in which we operate in substantial ways. In addition, state governments have adopted, and will continue to adopt, changes to their existing laws and regulations in light of Healthcare Reform and related regulations. Future changes may, or may not, be beneficial to us, and may be contrary to current Federal rules.
Certain key members of Congress continue to express a desire to withhold the funding necessary for Healthcare Reform or the desire to repeal or amend all or a portion of Healthcare Reform. Any partial or complete repeal or amendment or implementation difficulties, or uncertainty regarding such events, could increase our costs of compliance and adversely affect our results of operations and financial condition. Conversely, the enforcement of Healthcare Reform and regulations promulgated thereunder could have negative effects on us, including:
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increasing our competition;
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reducing or eliminating the need for health insurance agents and brokers and/or demand for the health insurance that we sell;
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decreasing the number of types of health insurance plans and products available for us to sell, as well as the number of insurance carriers offering such plans and products;
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causing insurance carriers to change the benefits and/or premiums for the plans and products they sell;
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causing insurance carriers to reduce the amount they pay for our services or change their relationships with us in other ways;
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causing IFP policyholders to pay the government a penalty or tax;
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making the cost of IMM more affordable through tax credits and subsidies;
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regulating out stand-alone HBIP;
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causing STM policies to be subject to MLR threshold requirements; or
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causing STM policies to be subject to “must carry” pre-existing condition requirements.
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Any of these effects could materially harm our business, results of operations and financial condition. For example, the manner in which the federal government and the states implement and enforce Healthcare Reform could substantially increase our competition and member turnover and substantially reduce the number of individuals who purchase insurance through us. Various aspects of Healthcare Reform could cause insurance carriers to limit the type of health insurance plans and products we are able to sell and the geographies in which we are able to sell them. Changes in the law could also cause insurance carriers to exit the business of selling insurance plans and products in a particular jurisdiction, to eliminate certain categories of products or to attempt to move members into new plans and products for which we receive lower commissions. If insurance carriers decide to limit our ability to sell their plans and products or determine not to sell individual health insurance plans and products altogether, our business, results of operations and financial condition could be materially harmed.
Persons who do not enroll in health care insurance plans with minimum essential coverage will be required to pay a penalty to the Internal Revenue Service which commenced in 2016, unless a hardship exception applies. The health insurance products that we sell are not deemed qualified insurance policies and will not exempt our members from these penalties. If the cost of the insurance policies that we sell, together with any penalties that our potential members could be required to pay, are not less than
the cost of qualifying health insurance policies, or our policies are otherwise perceived as inferior to qualifying insurance policies by potential members, our business, revenues and results of operations could be materially harmed.
If we or our independent distributors fail to comply with the numerous laws and regulations that are applicable to our business, our business and results of operations could be harmed.
The health insurance industry is heavily regulated by each state in the United States. For instance, state regulators require us to maintain a valid license in each state in which we transact health insurance business and further require that we adhere to sales, documentation and administration practices specific to each state. In addition, each distributor who transacts health insurance business on our behalf must maintain a valid license in one or more states. Because we do business in the majority of states and the District of Columbia, compliance with health insurance-related laws, rules and regulations is difficult and imposes significant costs on our business. Each jurisdiction’s insurance department typically has the power, among other things, to:
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grant suspend, and revoke licenses to transact insurance business;
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issue provisional or conditional licenses for probationary periods;
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conduct inquiries into the insurance-related activities and conduct of agents and agencies;
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require and regulate disclosure in connection with the sale and solicitation of health insurance;
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authorize how, by which personnel and under what circumstances insurance premiums can be quoted and published and an insurance policy can be sold;
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determine which entities can be paid commissions from carriers;
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regulate the content of insurance-related advertisements, including web pages;
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approve policy forms, require specific benefits and benefit levels and regulate premium rates;
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impose fines and other penalties;
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otherwise require changes to or impose conditions on how we or our distributors conduct business in their respective jurisdictions.
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Due to the complexity, periodic modification and differing interpretations of insurance laws and regulations and the number of third parties with which we have relationships, we may not have always been, and we and/or our independent distributors may not always be, in compliance with such laws and regulations. Failure to comply could result in significant liability, additional state insurance licensing requirements or the revocation of licenses in a particular jurisdiction, which could significantly reduce our revenue, increase our operating expenses, prevent us from transacting health insurance business in a particular jurisdiction and otherwise harm our business, results of operations and financial condition. Moreover, an adverse regulatory action in one jurisdiction could result in penalties and adversely affect our license status or reputation in other jurisdictions due to the requirement that adverse regulatory actions in one jurisdiction be reported to other jurisdictions. Even if the allegations in any regulatory or other action against us are proven false, any surrounding negative publicity could harm member, distributor or health insurance carrier confidence in us, which could significantly damage our reputation. Because some members, distributors and health insurance carriers may not be comfortable with the concept of purchasing health insurance using the internet, any negative publicity may affect us more than it would others in the health insurance industry and could harm our business, results of operations and financial condition.
Because we depend, in part, on independent third-party distributors for the sale of our products, the failure of our distributors to comply with applicable laws and regulations could have an adverse effect on our business. For example, while we are not culpable for the actions or omissions of our independent third-party distributors, their actions or omissions could result in an investigation or regulatory action against our Company.
In addition, we have received and may in the future receive inquiries from state insurance regulators regarding our marketing and business practices and the practices of our independent third-party distributors and carriers. We may modify our practices in connection with any such inquiry, and we may require our distributors to change their practices, or we may be forced to terminate distributors. In 2016, we terminated two of our largest independent distributors for their failure to comply with our compliance
standards. Any modification, or penalty for noncompliance, of our marketing or business practices in response to regulatory inquiries could harm our business, results of operations or financial condition.
For additional information regarding our current state insurance regulatory matters, see Note 12 “Commitments and Contingencies” in Part IV, Item 15 of this report.
Regulation of the sale of health insurance is subject to change, and future regulations could harm our business and results of operations.
The laws and regulations governing the offer, sale and purchase of health insurance are subject to change, and future changes may be adverse to our business. For example, once health insurance pricing is set by the insurance carrier and approved by state regulators, it is fixed and not generally subject to negotiation or discounting by insurance companies or agents. Additionally, state regulations generally prohibit insurance carriers, agents and brokers from providing financial incentives, such as rebates, to their members in connection with the sale of health insurance. As a result, we do not currently compete with insurance carriers or other agents and brokers on the price of the health insurance products offered on our distribution platform. We currently base our revenue structure on various commissions and fees, including commissions from insurance premiums and enrollment, monthly administrative fees and discount benefit fees. However, future laws and regulations could negatively adjust the commissions and fees we receive. If current laws or regulations change, we could be forced to reduce prices, commissions and fees or provide rebates or other incentives for the health insurance products sold through our online platform, which could harm our business, results of operations and financial condition.
Because we use the internet as our distribution platform, we are subject to additional insurance regulatory risks. In many cases, it is not clear how existing insurance laws and regulations apply to internet-related health insurance advertisements and transactions. To the extent that new laws or regulations are adopted that conflict with the way we conduct our business, or to the extent that existing laws and regulations are interpreted adversely to us, our business, results of operations and financial condition would be harmed.
Changes in the quality and affordability of the health insurance plans and products that insurance carriers offer to us for sale through our technology platform could harm our business and results of operations.
The demand for health insurance marketed through our technology platform is affected by, among other things, the variety, quality and price of the health insurance plans and products we offer. If health insurance carriers do not continue to allow us to sell a variety of high-quality, affordable health insurance plans and products in our markets, or if their offerings are limited or terminated as a result of consolidation in the health insurance industry, the implementation of Healthcare Reform or otherwise, our sales may decrease and our business, results of operations and financial condition could be harmed.
If individuals or insurance carriers opt for more traditional or alternative channels for the purchase and sale of health insurance, our business could be harmed.
Our success depends in part upon continued growth in the use of the internet as a source of research on health insurance products and pricing, as well as willingness for individuals to use the internet to request further information or contact directly or indirectly the distributors that sell the products we offer. Individuals and insurance carriers may choose to depend more on traditional sources, such as individual agents, or alternative sources may develop, including as a result of Healthcare Reform. Our future growth, if any, will depend in part upon:
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the growth of the internet as a commerce medium generally, and as a market for individual health insurance plans and services specifically;
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individuals’ willingness and ability to conduct their own health insurance research;
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our ability to make the process of purchasing health insurance online an attractive alternative to traditional and new means of purchasing health insurance;
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our ability to successfully and cost-effectively market our services as superior to traditional or alternative sources for health insurance to a sufficiently large number of individuals; and
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insurance carriers’ willingness to use us and the internet as a distribution channel for health insurance plans and products.
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If individuals and carriers determine that other sources of health insurance and health insurance applications are superior, our business will not grow and our results of operations and financial condition could be harmed.
Any legal liability, regulatory penalties, or negative publicity for the information on our platform or that we otherwise distribute or provide could likely harm our business and results of operations.
We provide information on our platform, through our call center partners and in other ways, regarding health insurance in general and the health insurance plans and products we market and sell, including information relating to insurance premiums, coverage, benefits, provider networks, exclusions, limitations, availability, plan and premium comparisons and insurance company ratings. A significant amount of both automated and manual effort is required to maintain the considerable amount of insurance plan information on our platform. We also regularly provide health insurance plan information in the scripts used by our customer call center partners. If the information we provide on our platform, through our customer call center partners or otherwise is not accurate or is construed as misleading, or if we do not properly assist individuals and businesses in purchasing health insurance, members, insurance carriers and others could attempt to hold us liable for damages, our relationships with insurance carriers could be terminated and regulators could attempt to subject us to penalties, revoke our licenses to transact health insurance business in a particular jurisdiction, and/or compromise the status of our licenses to transact health insurance business in other jurisdictions, which could result in our loss of our commission revenue. In the ordinary course of operating our business, we have received complaints that the information we provided was not accurate or was misleading. Although in the past we have resolved these complaints without significant financial cost, we cannot guarantee that we will be able to do so in the future. In addition, these types of claims could be time-consuming and expensive to defend, could divert our management’s attention and other resources and could cause a loss of confidence in our services. As a result, these types of claims could harm our business, results of operations and financial condition.
Additionally, we are subject to various federal and state telemarketing regulations, including the Telephone Consumer Protection Act (“TCPA”) and the FCC’s implementing regulations, as well as various state telemarketing laws and regulations. We, our distributors, and our carriers have been, and may continue to be, the subject of allegations of TCPA violations, and we could be responsible for some of the costs incurred by distributors or carriers who are the subject of allegations of TCPA violations. Any violation of these regulations could expose us to damages for monetary loss, statutory damages, fines, penalties and/or regulatory inquiries. The Company has received a number of private-party TCPA claims relating to independently owned and operated third-party licensed-agent distributors, alleging that their marketing activities were potentially unlawful. The Company has been named as a defendant in multiple lawsuits relating to alleged TCPA matters, including claims styled, but not yet certified, as class actions.
In the ordinary course of our business, we have received, and may continue to receive, inquiries from state regulators relating to various matters or in the future become involved in litigation. Also from time to time, we may be a party to litigation and subject to civil claims incident to the ordinary course of business, including claims from consumers alleging misrepresentation and material omissions in connection with their purchase of our products. For information regarding our current regulatory matters, see Note 12 “Commitments and Contingencies” in Part IV, Item 15 of this report. If we are found to have violated laws or regulations, we could lose our relationship with insurance carriers and be subject to various fines and penalties, including revocation of our licenses to sell insurance, and our business, results of operations and financial condition would be materially harmed. We could also be harmed to the extent that related publicity damages our reputation as a trusted source of information relating to health insurance and its affordability. It could also be costly to defend ourselves regardless of the outcome. As a result, inquiries from regulators or our becoming involved in litigation could adversely affect our business, results of operations and financial condition.
Advance commission arrangements between us and some of our third-party distributors expose us to the credit risks of such distributors, which could in turn have an adverse effect on our business, financial condition, and results of operations.
We make advance commission payments to many of our independent distributors in order to assist them with the cost of lead acquisition and provide working capital. As of December 31, 2017, we had a balance outstanding for advanced commissions of approximately
$39.5 million
under such arrangements of which approximately
$26.8 million
is with three distributors. Of the three, one distributor accounts for approximately
$14.2 million
or
35.8%
of the total outstanding balance. In most cases where we make advance commission payments, we receive security interests in collateral, as well as personal and entity-level guarantees. At a minimum, our collateral includes a claim against all future compensation owed to the distributor for all products sold. As a result, our claims for such payments would usually be considered secured claims. Depending on the amount of future compensation owed to the distributor, we could be exposed to the credit risks of our third-party distributors in the event of their insolvency or bankruptcy. Where the amount owed to us exceeds the value of the collateral, our claims against the defaulting distributors would rank below those of certain other secured creditors, which could undermine our chances of obtaining the return of our advance commission payments. We may not be able to recover such advance payments and we may suffer losses should the independent distributors fail to fulfill their sales obligations under the contracts. Accordingly, any of the above scenarios could harm our business, results of operations and financial condition.
Seasonality could cause fluctuations in our financial results.
Our business of marketing IFP and supplemental plans is subject to seasonal fluctuations that we believe have been impacted by Healthcare Reform. Under Healthcare Reform, the PPACA open enrollment period was open in the fourth quarter of 2017, at which time individuals could enroll in ACA compliant individual insurance programs. During the times that the open enrollment period is closed, we have the capability to sell our IFP products as an alternative health insurance option for consumers who are ineligible for plans offered by PPACA. Other seasonality trends may develop and the existing seasonality and consumer behavior that we have experienced may change as the implementation and enforcement of Healthcare Reform continues and our markets continue to change. Any seasonality that we experience could cause fluctuations in our financial results.
If we are unable to successfully introduce new technology solutions or services or fail to keep pace with advances in technology, our business, financial condition and results of operations could be adversely affected.
Our business depends on our ability to adapt to evolving technologies and industry standards and introduce new technology solutions and services accordingly. If we cannot adapt to changing technologies, our technology solutions and services may become obsolete, and our business would suffer. Because the healthcare insurance market is constantly evolving, our existing technology may become obsolete and fail to meet the requirements of current and potential members. Our success will depend, in part, on our ability to continue to enhance our existing technology solutions and services, develop new technology that addresses the increasingly sophisticated and varied needs of our members and respond to technological advances and emerging industry standards and practices on a timely and cost-effective basis. The development of our online platform entails significant technical and business risks. We may not be successful in developing, using, marketing, or maintaining new technologies effectively or adapting our technology to evolving customer requirements or emerging industry standards, and, as a result, our business and reputation could suffer. We may not be able to introduce new technology solutions on schedule, or at all, or such solutions may not achieve market acceptance. We also engage third-party vendors to develop, maintain and enhance our technology solutions, and our ability to develop and implement new technologies is therefore dependent on our ability to engage suitable vendors. We may also need to license software or technology from third parties in order to maintain, expand or modify our technology platform. However, there is no guarantee we will be able to enter into such agreements on acceptable terms or at all. Moreover, competitors may develop competitive products that could adversely affect our results of operations. A failure by us to introduce new solutions or to introduce these solutions on schedule could have an adverse effect on our business, financial condition and results of operations.
Our failure to obtain, maintain and enforce the intellectual property rights on which our business depends could have a material adverse effect on our business, financial condition and results of operations.
We rely upon intellectual property laws in the United States, and although we do not have any patents protecting our business model or technology, we rely on non-disclosure, confidentiality and other types of agreements with our employees, members and other parties, to establish, maintain and enforce our intellectual property and proprietary rights. However, any of our owned or licensed intellectual property rights could be challenged, invalidated, circumvented, infringed or misappropriated, our trade secrets and other confidential information could be disclosed in an unauthorized manner to third-parties, or our intellectual property rights may not be sufficient to permit us to take advantage of current market trends or otherwise to provide us with competitive advantages, which could result in costly redesign efforts, discontinuance of certain offerings or other competitive harm. Efforts to enforce our intellectual property rights may be time consuming and costly, distract management’s attention and resources and ultimately be unsuccessful. In addition, such efforts may result in our intellectual property rights being challenged, limited in scope, or declared
invalid or unenforceable. Moreover, our failure to develop and properly manage new intellectual property could adversely affect our market positions and business opportunities. Our intellectual property rights may not prevent others from creating a competitive online platform or otherwise competing with us.
We may not be able to obtain, maintain and enforce the intellectual property rights that may be necessary to protect and grow our business and to provide us with a meaningful competitive advantage. Also, some of our business and services may rely on technologies and software developed by or licensed from third-parties, and we may not be able to maintain our relationships with such third-parties or enter into similar relationships in the future on reasonable terms or at all. Our failure to obtain, maintain and enforce our intellectual property rights could therefore have a material adverse effect on our business, financial condition and results of operations.
Assertions by third-parties that we violate their intellectual property rights could have a material adverse effect on our business, financial condition and results of operations.
Third-parties may claim that we, our members, or parties indemnified by us are infringing upon or otherwise violating their intellectual property rights. Such claims may be made by competitors seeking to obtain a competitive advantage or by other parties. Additionally, in recent years, individuals and groups have begun purchasing intellectual property assets for the purpose of making claims of infringement and attempting to extract settlements from companies like ours. Any claims that we violate a third-party’s intellectual property rights can be time consuming and costly to defend and distract management’s attention and resources, even if the claims are without merit. Such claims may also require us to redesign affected products and services, enter into costly settlement or license agreements or pay costly damage awards, or face a temporary or permanent injunction prohibiting us from marketing or providing the affected products and services. Even if we have an agreement entitling us to indemnity against such costs, the indemnifying party may be unable to uphold its contractual obligations. If we cannot or do not license the infringed technology at all, license the technology on reasonable terms or substitute similar technology from another source, our revenue and earnings could be adversely impacted.
In addition, we may use open source software in connection with our products and services. Companies that incorporate open source software into their products have, from time to time, faced claims challenging the ownership of open source software and/or compliance with open source license terms. As a result, we could be subject to suits by parties claiming ownership of what we believe to be open source software or noncompliance with open source licensing terms. Some open source software licenses require users who distribute open source software as part of their software to publicly disclose all or part of the source code to such software and/or make available any derivative works of the open source code on unfavorable terms or at no cost. Any requirement to disclose our proprietary source code or pay damages for breach of contract could have a material adverse effect on our business, financial condition and results of operations.
Assertions by third-parties that we violate their intellectual property rights could therefore have a material adverse effect on our business, financial condition and results of operations.
If we fail to effectively manage our growth, our business and results of operations could be harmed.
We have expanded our operations significantly since our initial public offering in 2013. This has significantly increased the demands on our management, our operational and financial systems and infrastructure and other resources. If we do not effectively manage our growth, the quality of our services could suffer. In order to successfully expand our business, we must effectively integrate, develop and motivate new employees, and we must maintain the beneficial aspects of our corporate culture. We may not be able to hire new employees quickly enough to meet our needs. If we fail to effectively manage our hiring needs and successfully integrate our new hires, our efficiency and ability to meet our forecasts and our employee morale, productivity and retention could suffer, and our business and results of operations could be harmed. We also need to continue to improve our existing systems for operational and financial management, including our reporting systems, procedures and controls. These improvements could require significant capital expenditures and place increasing demands on our management. We may not be successful in managing or expanding our operations or in maintaining adequate financial and operating systems and controls. If we do not successfully manage these processes, our business and results of operations could be harmed.
If we are unable to maintain a high level of service, our business and prospects could be harmed.
One of the key attributes of our business is providing high quality service to our insurance carriers, distributors and members. We may be unable to sustain these levels of service, which would harm our reputation and our business. Alternatively, we may only be able to sustain high levels of service by significantly increasing our operating costs, which would materially adversely affect our results of operations. The level of service we are able to provide depends on our personnel to a significant extent. Our personnel must be well-trained in our processes and able to handle member calls effectively and efficiently. Any inability of our
personnel to meet our demand, whether due to absenteeism, training, turnover, disruptions at our facilities, bad weather, power outages or other reasons, could adversely impact our business. If we are unable to maintain high levels of service performance, our reputation could suffer and our results of operations and prospects could be harmed.
We are subject to privacy and data protection laws governing the transmission, security and privacy of health information, which may impose restrictions on the manner in which we access personal data and subject us to penalties if we are unable to fully comply with such laws.
Numerous federal, state and international laws and regulations govern the collection, use, disclosure, storage and transmission of individually identifiable health information. These laws and regulations, including their interpretation by governmental agencies, are subject to frequent change. These regulations could have a negative impact on our business, for example:
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HIPAA and its implementing regulations were enacted to ensure that employees can retain and at times transfer their health insurance when they change jobs, and to simplify healthcare administrative processes. The enactment of HIPAA also expanded protection of the privacy and security of personal health information and required the adoption of standards for the exchange of electronic health information. Among the standards that the Department of Health and Human Services has adopted pursuant to HIPAA are standards for electronic transactions and code sets, unique identifiers for providers, employers, health plans and individuals, security, electronic signatures, privacy and enforcement. Failure to comply with HIPAA could result in fines and penalties that could have a material adverse effect on us.
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The HITECH Act sets forth health information security breach notification requirements and increased penalties for violation of HIPAA. The HITECH Act requires individual notification for all breaches, media notification of breaches of over 500 individuals and at least annual reporting of all breaches to the Department of Health and Human Services. The HITECH Act also replaced the prior penalty system of one tier of penalties of $100 per violation and an annual maximum of $25,000 with a four-tier system of sanctions for breaches. Penalties now range from the original $100 per violation and an annual maximum of $25,000 for the first tier to a fourth-tier minimum of $50,000 per violation and an annual maximum of $1.5 million. Failure to comply with the HITECH Act could result in fines and penalties that could have a material adverse effect on us.
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Other federal and state laws restricting the use and protecting the privacy and security of individually identifiable information may apply, many of which are not preempted by HIPAA.
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Federal and state consumer protection laws are increasingly being applied by the FTC, and states’ attorneys general to regulate the collection, use, storage and disclosure of personal or individually identifiable information, through websites or otherwise, and to regulate the presentation of website content.
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We are required to comply with federal and state laws governing the transmission, security and privacy of individually identifiable health information that we may obtain or have access to in connection with the provision of our services. Despite the security measures that we have in place to ensure compliance with privacy and data protection laws, our facilities and systems, and those of our third-party vendors and subcontractors, are vulnerable to security breaches, acts of vandalism or theft, computer viruses, misplaced or lost data, programming and human errors or other similar events. Due to the enactment of the HITECH Act, we are not able to predict the extent of the impact such incidents may have on our business. Our failure to comply may result in criminal and civil liability because the potential for enforcement action against business associates is now greater. Enforcement actions against us could be costly and could interrupt regular operations, which may adversely affect our business. While we have received inquiries relating to our compliance with various privacy acts, including inquiries originating from allegations of a potential breach, to date none have been found or determined to be actual violations by our Company.
Under the HITECH Act, as a business associate we may also be directly or independently liable for privacy and security breaches and failures of our subcontractors. Even though we provide for appropriate protections through our agreements with our subcontractors, we still have limited control over their actions and practices. A breach of privacy or security of individually identifiable health information by a subcontractor may result in an enforcement action, including criminal and civil liability, against us. In addition, numerous other federal and state laws protect the confidentiality of individually identifiable information as well as employee personal information, including state medical privacy laws, state social security number protection laws, and federal and state consumer protection laws. These various laws in many cases are not preempted by HIPAA and may be subject to varying interpretations by the courts and government agencies, creating complex compliance issues for us and our members and potentially exposing us to additional expense, adverse publicity and liability, any of which could adversely affect our business.
Our business is subject to online security risks, and if we are unable to safeguard the security and privacy of confidential data, our reputation and business could be harmed.
Our services involve the collection and storage of confidential information of members and the transmission of this information to insurance carriers. For example, we collect names, addresses, and social security, bank account and credit card numbers, as well as information regarding the medical history of members in connection with their applications for insurance. In certain cases such information is provided to third-parties, such as to the service providers who provide hosting services for our technology platform, and we may therefore be unable to control the use of such information or the security protections employed by such third-parties. We may be required to expend significant capital and other resources to protect against security breaches or to alleviate problems caused by security breaches. Despite our implementation of security measures, techniques used to obtain unauthorized access or to sabotage systems change frequently, and our information technology and infrastructure may be vulnerable to attacks by hackers or breached due to employee error, malfeasance or other disruptions. As a result, we may be unable to anticipate these techniques or to implement adequate preventative measures. Any compromise or perceived compromise of our security (or the security of our third-party service providers who have access to our members’ confidential information) could damage our reputation and our relationship with members, third-party distributors and insurance carriers, could reduce demand for our services and could subject us to significant liability as well as regulatory action. In addition, in the event that new data security laws are implemented, or our insurance carriers or other partners determine to impose new requirements on us relating to data security, we may not be able to timely comply with such requirements, or such requirements may not be compatible with our current processes. Changing our processes could be time consuming and expensive, and failure to timely implement required changes could result in our inability to sell health insurance plans and products in a particular jurisdiction or for a particular insurance carrier, or subject us to liability for non-compliance.
Our services present the potential for embezzlement, identity theft or other similar illegal behavior by our employees or subcontractors with respect to third-parties.
Among other things, our services involve handling information from members, including credit card information and bank account information. Our services also involve the use and disclosure of personal information that could be used to impersonate third-parties or otherwise gain access to their data or funds. If any of our employees or subcontractors takes, converts or misuses such funds, documents or data, we could be liable for damages, and our business reputation could be damaged. In addition, we could be perceived to have facilitated or participated in illegal misappropriation of funds, documents or data and therefore be subject to civil or criminal liability. Any such illegal activity by our employees or subcontractors could have an adverse effect on our business, financial condition and results of operations.
System failures or capacity constraints could harm our business and results of operations.
The performance, reliability and availability of our technology platform, customer service call center and underlying network infrastructures are critical to our financial results and our relationship with members, independent distributors and insurance carriers. Although we regularly attempt to enhance and maintain our technology platform, customer service call center and system infrastructure, system failures and interruptions may occur if we are unsuccessful in these efforts. We may further experience difficulties with transitioning existing systems to upgraded systems, if we are unable to accurately project the rate or timing of increases in our platform traffic or customer service call center call volume or for other reasons, some of which are completely outside our control. Significant failures and interruptions, particularly during peak enrollment periods, could harm our business, results of operations and financial condition.
We rely in part upon third-party vendors, including data center and bandwidth providers, to operate and maintain our technology platform. We cannot predict whether additional network capacity will be available from these vendors as we need it, and our network or our suppliers’ networks might be unable to achieve or maintain a sufficiently high capacity of data transmission to allow us to process health insurance applications in a timely manner or effectively download data, especially if our platform traffic increases. Any system failure that causes an interruption in, or decreases the responsiveness of, our services could impair our revenue-generating capabilities, harm our image and subject us to potential liability. Our database and systems are vulnerable to damage or interruption from human error, earthquakes, fire, floods or other weather events, power loss, telecommunications failures, physical or electronic break-ins, computer viruses, acts of terrorism, other attempts to harm our systems and similar events.
We depend upon third parties, including telephone service providers, third-party software providers and business process outsourcing providers, to operate our customer service call center. Any failure of the systems upon which we rely in the operation of our customer service call center could negatively impact sales as well as our relationship with members, which could harm our business, results of operations and financial condition.
Insurance carriers and distributors depend upon third-party service providers to access our online platform, and our business and results of operations could be harmed as a result of technical difficulties experienced by these service providers.
Insurance carriers and distributors using our online platform depend upon internet and other service providers for access to our platform. Many of these service providers have experienced significant outages, delays and other difficulties in the past and could experience them in the future. Any significant interruption in access to our technology platform or increase in our platform’s response time as a result of these difficulties could damage our relationship with insurance carriers, third-party distributors and existing and potential members and could harm our business, results of operations and financial condition.
Economic conditions and other factors beyond our control may negatively impact our business, results of operations and financial condition.
Our revenue depends upon demand for our insurance products, which can be influenced by a variety of factors beyond our control. We have no control over the economic and other factors that influence such demand. Any softening of demand for our products and the services offered by us, whether caused by changes in individual preferences or the regulated environment in which we operate, or by a weak economy, will result in decreased revenue and growth. Members may attempt to reduce expenses by canceling existing plans and products purchased through us, not purchasing new plans and products through us or purchasing plans with lower premiums for which we receive lower commissions. A negative economic environment could also adversely impact the insurance carriers whose plans and products are offered on our platform, and they may, among other things, determine to reduce their commission rates, increase premiums or reduce benefits, any of which could negatively impact our business, results of operations and financial condition.
To the extent the economy or other factors adversely impact our member retention, the number or type of insurance applications submitted through us and that are approved by insurance carriers, or the commissions that we receive from insurance carriers, our rate of growth will decline and our business and results of operations will be harmed.
The loss of any member of our management team and our inability to make up for such loss with a qualified replacement could harm our business.
Competition for qualified management in our industry is intense. Many of the companies with which we compete for management personnel have greater financial and other resources than we do or are located in geographic areas which may be considered by some to be more desirable places to live. If we are not able to retain any of our key management personnel, our business could be harmed.
Our acquisitions and other strategic transactions may be difficult to integrate, divert management resources, result in unanticipated costs or dilute our stockholders.
Part of our continuing business strategy is to acquire or invest in, companies, products or technologies that complement our current products, enhance our market coverage, technical capabilities or production capacity, or offer growth opportunities or make other strategic transactions. Such transactions could pose numerous risks to our operations, including:
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difficulty integrating the purchased operations, technologies or products;
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incurring substantial unanticipated integration costs;
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assimilating the acquired businesses may divert significant management attention and financial resources from our other operations and could disrupt our ongoing business;
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acquisitions could result in the loss of key employees, particularly those of the acquired operations;
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difficulty retaining or developing the acquired businesses’ customers;
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acquisitions could adversely affect our existing business relationships with suppliers and members;
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failing to realize the potential cost savings or other financial benefits and/or the strategic benefits of the acquisitions; and
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incurring liabilities from the acquired businesses for infringement of intellectual property rights or other claims, and we may not be successful in seeking indemnification for such liabilities or claims.
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In connection with these acquisitions or investments, we could incur debt, amortization expenses related to intangible assets, large and immediate write-offs, assume liabilities or issue stock that would dilute our current stockholders’ percentage of ownership. We may not be able to complete acquisitions or integrate the operations, products or personnel gained through any such acquisition without a material adverse effect on our business, financial condition and results of operations.
AgileHealthInsurance® depends upon marketing partnerships to attract a significant portion of the consumers who visit our website, and Agile’s success is dependent on our ability to maintain effective relationships with our existing marketing partners and establish successful relationships with new marketing partners.
We enter into contractual marketing relationships with online and offline businesses that promote AgileHealthInsurance® to its customers and users. These marketing partners include online advertisers, content providers and insurance lead aggregators, and we typically compensate our marketing partners for their online referrals (clickthroughs) on a performance basis (CPA or CPC). If we are unable to maintain successful relationships with our existing marketing partners or fail to establish successful relationships with new marketing partners, our business, results of operations and financial condition will be harmed. Additionally, if competition increases with respect to marketing partner relationships, this would increase the cost of compensation agreements with marketing partners and increase the marketing expenses associated with these partners.
AgileHealthInsurance
®
depends upon internet search engines to attract a significant portion of the consumers who visit our direct to consumer website.
We derive a significant portion of our AgileHealthInsurance
®
website traffic from consumers who search for health insurance through internet search engines. A critical factor in attracting consumers to our website is whether we are prominently displayed in response to internet searches broadly relating to health insurance topics. Search engines typically provide two types of search results, algorithmic listings and paid advertisements. We rely on both algorithmic listings and paid advertisements to attract consumers to our website.
Algorithmic search result listings are determined and displayed in accordance with a set of formulas or algorithms developed by the particular internet search engine. The algorithms determine the order of the listing of results in response to the consumer’s internet search. From time to time, search engines update these algorithms. In some instances, these modifications have caused our AgileHealthInsurance
®
website to be listed less prominently in algorithmic search results, which has resulted in decreased traffic to our website. We may also be listed less prominently as a result of new websites or changes to existing websites that result in these websites receiving higher algorithmic rankings with the search engine. For example, during PPACA open enrollment, health insurance exchange websites may appear more prominently in algorithmic search results. In addition, our AgileHealthInsurance
®
website may become listed less prominently in algorithmic search results for other reasons, such as search engine technical difficulties, search engine technical changes and changes we make to our website. In addition, search engines have deemed the practices of some companies to be inconsistent with search engine guidelines and decided not to list their website in search result listings at all. If we are listed less prominently in, or removed altogether from, search result listings for any reason, the traffic to our website could decline and we may not be able to replace this traffic, which in turn could harm our business, operating results and financial condition. If we decide to attempt to replace this traffic, we may be required to increase our marketing expenditures, which would also increase our cost of acquisition and harm our business, results of operations and financial condition.
We purchase paid advertisements on search engines in order to attract consumers to our website. We typically pay a search engine for prominent placement of the Agile name and website when particular health insurance-related terms are searched for on the search engine, regardless of the algorithmic search result listings. In some circumstances, the prominence of the placement of our advertisement is determined by a combination of factors, including the amount we are willing to pay and algorithms designed to determine the relevance of our paid advertisement to a particular search term. As with algorithmic search result listings, search engines may revise the algorithms relevant to paid advertisements and websites other than our platform may become more optimized for the algorithms. These changes may result in our having to pay increased amounts to maintain our paid advertisement placement in response to a particular search term. We could also have to pay increased amounts should the market share of major search engines continue to become more concentrated with a single search engine. Additionally, we bid against our competitors and others for the display of these paid search engine advertisements. Many of our competitors, including many health insurance carriers and government-run health insurance exchanges, have greater resources with which to bid and better brand recognition than we do. We have experienced increased competition from health insurance carriers and some of our marketing partners for both algorithmic search result listings and for paid advertisements, which has increased our marketing and advertising expenses. If this competition increases further, or if the fees associated with paid search advertisements increase as a result of algorithm changes or other factors, our advertising expenses could rise significantly or we could reduce or discontinue our paid search advertisements, either of which could harm our business, results of operations and financial condition.
The success of our direct-to-consumer channel depends on the continuation of private health insurance plans available for consumer purchase.
Our ability to attract consumer traffic to and generate member interest for AgileHealthInsurance
®
is predicated on a health insurance market where consumers have the need for private health insurance and have a plurality of options from which to choose. Should the government regulations reduce or eliminate the availability of health insurance plans provided by private commercial entities then our ability to produce online direct to consumer sales could be jeopardized.
The requirements of being a public company impose costs and demands upon our management, which could make it difficult to manage our business, particularly after we are no longer an “emerging growth company.”
Complying with the reporting and other regulatory requirements of the Securities Exchange Act of 1934 (as amended, the “Exchange Act”) and the requirements of the Sarbanes-Oxley Act of 2002 (as amended, the “Sarbanes-Oxley Act”) is time-consuming and costly and could have a negative effect on our business, financial condition and results of operations. The Exchange Act requires that we file annual, quarterly and current reports with respect to our business and financial condition. The Sarbanes-Oxley Act requires that we maintain effective disclosure controls and procedures and internal controls over financial reporting. To maintain and improve the effectiveness of our disclosure controls and procedures and internal control over financial reporting, we have committed significant resources, hired additional staff and provided additional management oversight. We expect these resources and management oversight requirements to continue. These activities may divert management’s attention from other business concerns, which could have a material adverse effect on our business, financial condition and results of operations.
As an “emerging growth company” as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”), we benefit from certain temporary exemptions from various reporting requirements, including, but not limited to, not being required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act and reduced disclosure obligations regarding executive compensation in our periodic reports and proxy statements. In addition, we have elected under the JOBS Act to delay adoption of new or revised accounting pronouncements applicable to public companies until such pronouncements are made applicable to private companies. When these exemptions cease to apply, which for the Company will be on December 31, 2018, we expect to incur additional expenses and devote increased management effort toward ensuring compliance with them. We cannot predict or estimate the amount of additional costs we may incur as these exemptions cease to apply.
The implementation by us of the new revenue recognition standard on December 31, 2018 (ASC 606) requires substantial preparation and expenditures, and our failure to properly implement this standard could result in inaccurate revenue recognition and disclosure and cause us to fail to meet our financial reporting obligations.
In May 2014, the Financial Accounting Standards Board (FASB) issued new revenue recognition guidance under ASC 606, which, as an emerging growth company, is effective for us beginning December 31, 2018. Under this new guidance, revenue is recognized when promised goods or services are transferred to customers in an amount that reflects the consideration that is expected to be received for those goods or services. The new guidance also requires additional disclosure about the nature, amount, timing and uncertainty of revenue that is recognized.
In order to comply with the requirements of ASC 606 on December 31, 2018, we are continuing to update and enhance our internal accounting systems, processes, and our internal controls over financial reporting. This has required, and will continue to require, additional investments by us, and may require incremental resources and system configurations that could increase our operating costs in future periods. If we are not successful in updating our policies, procedures, information systems and internal controls over financial reporting, the revenue that we recognize and the related disclosures that we provide under ASC 606 may not be complete or accurate, which could harm our operating results or cause us to fail to meet our reporting obligations and adversely affect our stock price.
The application of the new standard will be based on all information available to us as of the date of adoption and up through subsequent interim reporting, including transition guidance published by the standard setters. However, we understand the interpretation of these new standards will continue to evolve as other public companies adopt ASC 606 and the standard setters issue new interpretive guidance related to these rules. As a result, changes in the interpretation of these rules could result in material adjustments to our application of the new standard, which could have a material adverse effect on our results of operations and financial condition.
Risks Related to Our Structure
We are a holding company and our only material asset is our interest in HPIH and, accordingly, we are dependent upon distributions from HPIH to pay taxes and other expenses.
We are a holding company and have no material assets other than our ownership of Series A Membership Interests of HPIH. We have no independent means of generating revenue. HPIH is treated as a partnership for U.S. federal income tax purposes and, as such, is not itself subject to U.S. federal income tax. Instead, its net taxable income is generally allocated to its members, including us,
pro rata
according to the number of Membership Interests each member owns. Accordingly, we incur income taxes on our proportionate share of any net taxable income of HPIH and also incur expenses related to our operations. We intend to cause HPIH to distribute cash to its members, including us, in an amount at least equal to the amount necessary to cover their respective tax liabilities, if any, with respect to their allocable share of the net income of HPIH and to cover dividends, if any, declared by us, as well as any payments due under the tax receivable agreement, as described below. To the extent that we need funds to pay our tax or other liabilities or to fund our operations, and HPIH is restricted from making distributions to us under applicable agreements, laws or regulations or does not have sufficient cash to make these distributions, we may have to borrow funds to meet these obligations and operate our business, and our liquidity and financial condition could be materially adversely affected. To the extent that we are unable to make payments under the income tax receivable agreement for any reason, such payments will be deferred and will accrue interest until paid.
We will be required to pay the existing and potential future holders of Series B Membership Interests of HPIH most of the tax benefits that we may receive as a result of any future exchanges of Series B Membership Interests for our Class A common stock and payments made under the tax receivable agreement itself, and the amounts we pay could be substantial.
We expect that any future exchanges of Series B Membership Interests (together with an equal number of shares of our Class B common stock) for shares of our Class A common stock will result in increases in the tax basis in our share of the tangible and intangible assets of HPIH. Any such increases in tax basis could reduce the amount of tax that we would otherwise be required to pay in the future.
We have entered into a tax receivable agreement with entities that hold Series B Membership Interests that are beneficially owned by Michael W. Kosloske, our founder, pursuant to which we will pay them 85% of the amount of the cash savings, if any, in U.S. federal, state and local income tax that we realize (or are deemed to realize in the case of an early termination payment by us, a change in control or a material breach by us of our obligations under the tax receivable agreement, as discussed below) as a result of these possible increases in tax basis resulting from exchanges of Series B Membership Interests as well as certain other benefits attributable to payments under the tax receivable agreement itself. Any actual increases in tax basis, as well as the amount and timing of any payments under the tax receivable agreement, cannot be predicted reliably at this time. The amount of any such increases and payments will vary depending upon a number of factors, including the timing of exchanges, the price of our Class A common stock at the time of the exchanges, the amount, character and timing of our income and the tax rates then applicable. The payments that we may be required to make pursuant to the tax receivable agreement could be substantial for periods in which we generate taxable income. Changes in factors such as the corporate income tax rate or our ability to generate taxable income in the future could impact our valuation allowance for the deferred tax asset resulting in a benefit or a charge during the period.
In addition, the tax receivable agreement provides that in the case that we exercise our right to early termination of the tax receivable agreement or in the case of a change in control or a material breach by us of our obligations under the tax receivable agreement, the tax receivable agreement will terminate, and we will be required to make a payment equal to the present value of future payments under the tax receivable agreement, which payment would be based on certain assumptions, including those relating to our future taxable income. In these situations, our obligations under the tax receivable agreement could have a substantial negative impact on our liquidity and could have the effect of delaying, deferring or preventing certain mergers, asset sales, other forms of business combinations or other changes of control. These provisions of the tax receivable agreement may result in situations where Mr. Kosloske may have interests that differ from or are in addition to those of our stockholders.
We may not be able to realize all or a portion of the tax benefits that are expected to result from future exchanges of Series B Membership Interests for our Class A common stock and payments made under the tax receivable agreement itself.
Our ability to benefit from any depreciation or amortization deductions or to realize other tax benefits that we currently expect to be available as a result of the increases in tax basis created by future exchanges of Series B Membership Interests (together with an equal number of shares of our Class B common stock) for our Class A common stock, and our ability to realize certain other tax benefits attributable to payments under the tax receivable agreement itself depend on a number of assumptions, including that we earn sufficient taxable income each year during the period over which such deductions are available and that there are no adverse changes in applicable law or regulations. If our actual taxable income were insufficient and/or there were adverse changes
in applicable law or regulations, we may be unable to realize all or a portion of these expected benefits and our cash flows and stockholders’ equity could be negatively affected.
If the Internal Revenue Service successfully challenges the tax basis increases, we will not be reimbursed for any payments made under the tax receivable agreement (although future payments under the tax receivable agreement, if any, would be adjusted to reflect the result of any such successful challenge by the Internal Revenue Service). As a result, in certain circumstances, we could be required to make payments under the tax receivable agreement in excess of our cash tax savings.
Risks Related to Ownership of Our Class A Common Stock
We expect that our stock price will fluctuate significantly, and you may not be able to resell your shares at or above the purchase price.
We completed our IPO in February 2013. From that time through December 31, 2017, shares of our Class A common stock have traded between a low of $3.72 per share to a high of $37.38 per share. Several entities have reported owning, as of
December 31, 2017
, substantial portions of our Class A common stock. An active, liquid and orderly market for our Class A common stock may not be sustained, which could depress the market price of our Class A common stock and cause you to have difficulty selling any shares of our Class A common stock that you purchase at or above the price you paid or at all. In the future, the market price of our Class A common stock may be highly volatile and trading volumes may be low and could be subject to wide price fluctuations in response to various factors, including:
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market conditions in the broader stock market in general, or in our industry in particular;
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•
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actual or anticipated fluctuations in our quarterly financial and results of operations;
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•
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our ability to satisfy our ongoing capital needs and unanticipated cash requirements;
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•
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additional indebtedness incurred in the future;
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introduction of new products and services by us or our competitors;
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•
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issuance of new or changed securities analysts’ reports or recommendations;
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sales of large blocks of our stock;
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additions or departures of key personnel;
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•
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regulatory developments;
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•
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litigation and governmental investigations; and
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•
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economic and political conditions or events.
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These and other factors may cause the market price and demand for our Class A common stock to fluctuate substantially, which may limit or prevent investors from readily selling their shares of Class A common stock and may otherwise negatively affect the liquidity of our Class A common stock. In addition, in the past, when the market price of a stock has been volatile, holders of that stock have often instituted securities class action litigation against the company that issued the stock. If any of our stockholders brought a lawsuit against us, we could incur substantial costs defending the lawsuit. Such a lawsuit could also divert the time and attention of our management from our business.
The trading market for our Class A common stock may also be influenced by the research and reports that industry or securities analysts publish about us or our business. If one or more of these analysts cease coverage of our Company or fail to publish reports on us regularly, we could lose visibility in the financial markets, which in turn could cause our stock price or trading volume to decline. Moreover, if one or more of the analysts who cover us downgrades our stock, or if our results of operations do not meet their expectations, our stock price could decline.
The market price of our Class A common stock could decline due to future sales, or expected sales, of converted shares of Class A common stock, whether upon the exchange of Series B Membership Interests by our founder and largest stockholder or upon exercise of stock appreciation rights granted to employees and directors.
The market price of our Class A common stock could decline as a result of sales, or the possibility of sales, of a large number of shares of our Class A common stock eligible for future sale upon the exchange of Series B Membership Interests of HPIH (together with an equal number of shares of our Class B common stock) or upon the exercise of stock appreciation rights. These sales, or the perception that the sales may occur, may also make it more difficult for us to raise additional capital by selling equity securities in the future at a time and price that we deem appropriate. As of February 26, 2018, there were 3,841,667 Series B Membership Interests outstanding and held by entities owned by Michael Kosloske, our founder and largest stockholder. As required by a registration rights agreement between the Company and Mr. Kosloske’s affiliate entities, there is an effective registration statement covering the resale of Class A common stock that is issuable in exchange for the Series B Membership Interests owned by Mr. Kosloske’s affiliates, although the holders of the interests are under no obligation to effectuate exchanges and resell the shares they receive. Under the registration rights agreement, Mr. Kosloske has the right, among other things, to sell the shares covered by the effective registration statement in an underwritten offering and to require the Company to provide assistance in connection with any such offering, such as by filing one or more prospectus supplements. In addition to the shares held by Mr. Kosloske’s affiliated entities, as of February 26, 2018, there were approximately 1.0 million outstanding stock appreciation rights held by our directors and executive officers that are exercisable for shares of our Class A common stock.
Our share price may be adversely affected by short sellers and other third parties who raise questions about the Company.
Short sellers and others who raise questions about the Company, some of whom are positioned to profit if our share price declines, can negatively affect the price and volatility of our shares. On September 11, 2017, a short-seller of our common stock distributed a report raising questions about, among other things, the Company’s public disclosures relating to the Company’s regulatory examinations and regulatory compliance. Following the distribution of this report, the Company’s common stock experienced a significant decline in trading price. On September 28, 2017, another short-seller published a follow-on report raising questions about the Company, and thereafter other publications serving the short-selling community have published follow-on pieces about the Company questioning, among other things, the sales practices of its distributors.
Short sellers make a profit when our common shares decline in value, and their actions and public statements, together with the resulting publicity, may cause further volatility in our share price. The volatility of our stock may cause the value of a shareholder’s investment to decline rapidly. These short seller publications are not regulated by any governmental, self-regulatory organization or other official authority in the U.S., are not subject to certification requirements imposed by the Securities and Exchange Commission and, accordingly, the opinions they express may be based on distortions or omissions of actual facts or, in some cases, fabrications of facts. In light of the limited risks involved in publishing such information and the significant profit that can be made from running just one successful short attack (together with the adverse financial consequences to short sellers of an increase in our stock price), short sellers may continue to issue reports in the future with respect to the Company.
We are currently subject to securities lawsuits and we may be subject to similar or other litigation in the future, which may divert management’s attention and have a material adverse effect on our business, financial condition and results of operations.
The market price of our common stock declined following the release of a short-seller publication on September 11, 2017 raising questions about our regulatory compliance and regulatory examinations. Following this decline in market price, three purported securities class actions were filed against us and certain current and former executive officers alleging that the Company made materially false or misleading statements or omissions relating to regulatory compliance matters, particularly regarding to the Company’s application for a third-party administrator license in the State of Florida. According to the complaints filed for these actions, the plaintiffs in these actions are seeking an undetermined amount of damages, interest, attorneys’ fees and costs on behalf of putative classes of individuals and entities that acquired shares of the Company’s common stock on periods ending September 11, 2017.
We will continue to incur legal fees in connection with these pending cases, including expenses for the reimbursement of legal fees of present and former officers under indemnification obligations. The expense of continuing to defend such litigation may be significant. We intend to defend these lawsuits vigorously, but there can be no assurance that we will be successful in any defense. If any of the lawsuits are adversely decided, we may be liable for significant damages directly or under our indemnification obligations, which could adversely affect our business, results of operations and cash flows. Further, the amount of time that will be required to resolve these lawsuits is unpredictable and these actions may divert management's attention from the day-to-day operations of our business, which could adversely affect our business, results of operations and cash flows.
We cannot predict the outcome of these lawsuits and we may be subject to other similar securities litigation in the future. Monitoring and defending against legal actions, whether or not meritorious, is time-consuming for our management and detracts from our ability to fully focus our internal resources on our business activities. In addition, we may incur substantial legal fees and costs in connection with litigation. Although we have insurance, coverage could be denied or prove to be insufficient. We are not currently able to estimate the possible cost to us from the currently pending lawsuits, and we cannot be certain how long it may take to resolve these matters or the possible amount of any damages that we may be required to pay. We have not established any reserves for any potential liability relating to these or future lawsuits. It is possible that we could, in the future, incur judgments or enter into settlements of claims for monetary damages. A decision adverse to our interests on these actions could result in the payment of substantial damages and could have a material adverse effect on our business, results of operations and financial condition. In addition, the uncertainty of the currently pending lawsuits could lead to more volatility in our stock price. The ultimate outcome of litigation could have a material adverse effect on our business and the trading price for our securities.
Some provisions of Delaware law, our amended and restated certificate of incorporation and amended and restated bylaws and the beneficial ownership of a large percentage of our shares by one person may deter third-parties from acquiring us.
Our amended and restated certificate of incorporation and amended and restated bylaws provide for, among other things:
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restrictions on the ability of our stockholders to fill a vacancy on the board of directors;
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prohibit stockholder action by written consent;
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prohibit cumulative voting in the election of directors, which would otherwise allow holders of less than a majority of stock to elect some directors;
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provide that special meetings of stockholders may be called only by the board of directors, the chairman of the board of directors or the chief executive officer;
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establish advance notice procedures for the nomination of candidates for election as directors or for proposing matters that can be acted upon at stockholder meetings;
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directors may be removed only for cause and only upon the affirmative vote of holders of at least 75% of all of the outstanding shares of our capital stock entitled to vote
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certain provisions of our amended and restated certificate of incorporation may only be amended upon the affirmative vote of holders of at least 75% of all of the outstanding shares of our capital stock entitled to vote; and
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the authorization of undesignated preferred stock, the terms of which may be established and shares of which may be issued without stockholder approval.
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These anti-takeover defenses, the beneficial ownership of a large percentage of our shares by one person and other factors could discourage, delay or prevent a transaction involving a change in control of our Company. These provisions could also discourage proxy contests and make it more difficult for our stockholders to elect directors of their choosing and cause us to take other corporate actions that our stockholders desire.
We do not anticipate paying any cash dividends in the foreseeable future.
We currently intend to retain our future earnings, if any, for the foreseeable future to fund the development and growth of our business. We do not intend to pay any dividends to holders of our Class A common stock. As a result, capital appreciation in the price of our Class A common stock, if any, will be your only source of gain on an investment in our Class A common stock.
Our internal control over financial reporting may not be effective in the future, and our independent registered public accounting firm may not be able to certify as to its effectiveness, which could have a significant and adverse effect on our business and reputation.
If we fail in the future to achieve and maintain the adequacy of our internal controls, as such standards are modified, supplemented or amended from time to time, we may not be able to conclude, on an ongoing basis, that we have effective internal control over financial reporting in accordance with Section 404 of the Sarbanes-Oxley Act. If we are not able to comply with the requirements of Section 404 of the Sarbanes-Oxley Act, we may be subject to sanctions or investigation by regulatory authorities, such as the SEC. As a result, there could be a negative reaction in the financial markets due to a loss of confidence in the reliability
of our financial statements. In addition, we may be required to incur costs in improving our internal control system and the hiring of additional personnel. Any such action could negatively affect our results of operations and cash flows.
We are an “emerging growth company” and we cannot be certain if the reduced disclosure requirements applicable to emerging growth companies will make our Class A common stock less attractive to investors.
We are an “emerging growth company,” and we benefit from certain exemptions from various reporting requirements that are applicable to other public companies that are not “emerging growth companies” including, but not limited to, not being required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act, which may increase the risk that weaknesses or deficiencies in our internal control over financial reporting go undetected, and reduced disclosure obligations regarding executive compensation in our periodic reports and proxy statements, which may make it more difficult for investors and securities analysts to evaluate our Company. In addition, we have elected under the JOBS Act to delay adoption of new or revised accounting pronouncements applicable to public companies until such pronouncements are made applicable to private companies. As a result of this election, our financial statements may not be comparable to companies that comply with public company effective dates. If some investors find our Class A common stock less attractive as a result, there may be a less active trading market for our Class A common stock and our stock price may be more volatile. We may take advantage of these reporting exemptions until we are no longer an “emerging growth company,” which for the Company will be on December 31, 2018.
ITEM 1B. UNRESOLVED STAFF COMMENTS
None.
ITEM 2. PROPERTIES
As of
December 31, 2017
, we leased facilities in four different cities throughout the U.S. All properties are leased with various expiration dates. Our locations are summarized as follows:
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Location
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Approximate Square Footage
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Type of Interest
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Expiration of lease
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Tampa, FL
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15,700
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Leased
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December 2019
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Mountain View, CA
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1,700
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Leased
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October 2018
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Waxahachie, TX
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2,000
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Leased
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December 2019
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Haltom City, TX
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3,300
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Leased
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Month-to-month
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We believe that our properties are generally in good condition, well maintained and suitable and adequate to carry out our business at expected capacity for the foreseeable future. Should additional capacity become necessary in the future, we believe that suitable additional or alternative space will be available on commercially reasonable terms to accommodate our foreseeable future expansion.
ITEM 3. LEGAL PROCEEDINGS
Legal Proceedings are set forth under Note 12 "Commitments and Contingencies" included in Part IV, Item 15 of this Annual Report on Form 10-K, is incorporated herein by reference. For an additional discussion of certain risks associated with legal proceedings, see "Risk Factors" in Item 1A. above.
ITEM 4. MINE SAFETY DISCLOSURES
Not applicable.
PART II
ITEM 5. MARKET FOR REGISTRANT’S COMMON EQUITY, RELATED STOCKHOLDER MATTERS AND ISSUER PURCHASES OF EQUITY SECURITIES
Our Class A common stock is listed on the NASDAQ Global Market under the symbol “HIIQ.” On
February 26, 2018
, the last reported sale price of our Class A common stock on the NASDAQ Global Market was $30.95 per share. Our shares of Class A common stock have been publicly traded since February 8, 2013. Prior to that time there was no public market for our Class A common stock. The following table sets forth the high and low sales prices for our Class A common stock for the periods indicated as reported by the Nasdaq Global Market:
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High
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Low
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2017:
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First Quarter
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$
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21.00
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$
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13.80
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Second Quarter
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25.60
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15.00
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Third Quarter
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37.38
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12.65
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Fourth Quarter
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28.15
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14.35
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2016:
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First Quarter
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$
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6.81
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$
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5.39
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Second Quarter
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7.79
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3.93
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Third Quarter
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5.96
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3.84
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Fourth Quarter
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18.65
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4.85
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There is no public trading market for our Class B common stock.
HOLDERS
As of
February 26, 2018
, there were
12,731,758
shares of our Class A common stock and
3,841,667
shares of our Class B common stock issued. As of
February 26, 2018
, there were 9 Class A common stockholders of record and two Class B stockholders of record.
DIVIDEND POLICY
We have not declared dividends on our Class A common stock for the periods presented above. We currently anticipate that we will retain all available funds for use in the operation and expansion of our business, and do not anticipate paying any cash dividends in the foreseeable future. Class B common stock is not entitled to any dividend payments under our amended and restated certificate of incorporation.
UNREGISTERED SALES OF EQUITY SECURITIES
There were no unregistered sales of equity securities during the year ended
December 31, 2017
.
ISSUER PURCHASES OF EQUITY SECURITIES
Shares Repurchase Plan
On October 13, 2017, the Company’s Board of Directors authorized a share repurchase program for up to
$50.0 million
of the Company’s outstanding Class A Common Stock. The share repurchase authorization permits the Company to periodically repurchase shares for cash for a period of 24 months in open market purchases, block transactions and privately negotiated transactions in accordance with applicable federal securities laws. The actual timing, number and value of shares repurchased under the program will be determined by the Company’s management at its discretion and will depend on a number of factors, including the market price of the Company’s common stock, general market and economic conditions, regulatory requirements, capital availability and compliance with the terms of the Company’s credit facility. Repurchases under the program will be funded from one or a combination of existing cash balances, future free cash flow, and indebtedness. There is no guarantee as to the
number of shares that will be repurchased, and the repurchase program may be extended, suspended or discontinued at any time without notice at the Company’s discretion.
Under the stock repurchase program, the Company may elect to adopt a Rule 10b5-1 share repurchase plan under the Securities Exchange Act of 1934, as amended (a “10b5-1 Plan”). A 10b5-1 Pan, if adopted, would allow the Company to repurchase its shares at times when it otherwise might be prevented from doing so under insider trading laws or because of self-imposed trading blackout periods. Because repurchases under a 10b5-1 Plan, if one is adopted, are expected to be subject to certain pricing parameters, there is no guarantee as to the exact number of shares that would be repurchased under a 10b5-1 Plan.
During the year ended
December 31, 2017
, we repurchased
222,184
shares of our registered Class A common stock under our the repurchase program at an average price per share of
$22.15
. An aggregate of
75,000
shares were repurchased during November 2017 at an average price per share of
$22.81
, and an aggregate of
147,184
shares were repurchased during December 2017 at an average price per share of
$21.82
.
Employee Awards
Pursuant to certain restricted stock award agreements, we allow the surrender of restricted shares by certain employees to satisfy statutory tax withholding obligations on vested restricted stock awards.
The following table sets forth information with respect to repurchases of our registered Class A common stock during the fiscal quarter ended
December 31, 2017
:
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Period
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Total Number of Shares Repurchased (1)
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Average Price Paid per Share
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Total Number of Shares Purchased as Part of Publicly Announced Plans
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Maximum Number of Shares That May Yet be Purchased Under the Plans (2)
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October 1, 2017 through October 31, 2017
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644
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$
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21.95
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—
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—
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November 1, 2017 through November 30, 2017
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91,515
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22.84
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75,000
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2,570,502
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December 1, 2017 through December 31, 2017
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147,184
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21.82
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147,184
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2,423,318
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Total
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239,343
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222,184
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(1)
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Includes 17,159 shares that were surrendered by employees in order to satisfy statutory tax withholding obligations in connection with the vesting of stock-based compensation awards.
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(2)
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Maximum number of shares that may yet be repurchased under the plan is estimated by dividing the
$50.0 million
authorized for repurchase by the reported sale price of our Class A common stock on the NASDAQ Global Market of $18.90 on the date of plan adoption. The plan was announced on October 16, 2017, and expires after 24 months.
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ITEM 6. SELECTED FINANCIAL DATA
Pursuant to Rule 12b-2 and SEC Release No. 33-8876, a smaller reporting company transitioning to the larger reporting company system, is not required to satisfy a larger reporting company's reporting requirements until the first quarterly report on Form 10-Q for the following fiscal year. Under the disclosure requirements for a smaller reporting company, this information is not required to be provided.
ITEM 7. MANAGEMENT’S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS
Management’s Discussion and Analysis of Financial Condition and Results of Operations below presents the Company’s operating results for each of the two years in the period ended
December 31, 2017
, and its financial condition as of
December 31, 2017
. Except for the historical information contained herein, this report and other written and oral statements that the Company makes from time to time contain forward-looking statements, which involve substantial known and unknown risks, uncertainties and other important factors that could cause the actual results, performance or achievements of results to differ materially from
any future results, performance or achievements expressed or implied by such forward-looking statements. See the section of this report entitled “Special Note Regarding Forward-Looking Statements.” Among the factors that could cause actual results to differ materially are those discussed in “Risk Factors” in Item 1A of this report. In addition, the following Management’s Discussion and Analysis of Financial Condition and Results of Operations should be read in connection with the information presented in the Company’s consolidated financial statements and the related notes to its consolidated financial statements included in Part IV of this report.
Overview
Health Insurance Innovations, Inc. is a Delaware corporation incorporated on October 26, 2012. In this management's discussion and analysis, unless the context suggests otherwise, references to the “Company,” “we,” “us” and “our” refer (1) prior to our February 13, 2013 initial public offering (“IPO”) of the Class A common stock of Health Insurance Innovations, Inc., to Health Plan Intermediaries, LLC (“HPI”) and Health Plan Intermediaries Sub, LLC (“HPIS”), its consolidated subsidiary, and (2) after the IPO, to Health Insurance Innovations, Inc. and its consolidated subsidiaries. The terms “HIIQ” and “HPIH” refer to the stand-alone entities Health Insurance Innovations, Inc., and Health Plan Intermediaries Holdings, LLC, respectively. The terms “HealthPocket” or “HP” refer to HealthPocket, Inc., our wholly owned subsidiary which was acquired by HPIH on July 14, 2014. The term “ASIA” refers to American Service Insurance Agency LLC, a wholly owned subsidiary which was acquired by HPIH on August 8, 2014. HPIH, HP and ASIA are consolidated subsidiaries of HIIQ.
For a detailed description of our business, refer to "Overview" included in Part I, Item 1 "Business" or Note 1 of the accompanying consolidated financial statements.
Key Business Metrics
In addition to traditional financial metrics, we rely upon the following key business metrics to evaluate our business performance and facilitate long-term strategic planning:
Premium equivalents
. We define this metric as our total collections, including the combination of premiums, fees for discount benefit plans, enrollment fees, and third-party commissions and referral fees. All amounts not paid out as risk premium to carriers or paid out to other third-party obligors are considered to be revenues for financial reporting purposes. We have included premium equivalents in this report because it is a key measure used by our management to understand and evaluate our core operating performance and trends, to prepare and approve our annual budget and to develop short- and long-term operational plans. In particular, the inclusion of premium equivalents can provide a useful measure for period-to-period comparisons of our business. This financial measurement is considered a non-GAAP financial measure and is not recognized under generally accepted accounting principles in the United States of America (“GAAP”) and should not be used as, and is not an alternative to, revenues as a measure of our operating performance.
The following table presents a reconciliation of premium equivalents to revenues for the years ended
December 31, 2017
and
2016
($ in thousands):
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Premium equivalents
|
$
|
395,552
|
|
|
$
|
311,590
|
|
Less risk premium
|
138,880
|
|
|
121,436
|
|
Less amounts earned by third party obligors
|
6,196
|
|
|
5,638
|
|
Revenues
|
$
|
250,476
|
|
|
$
|
184,516
|
|
Policies in force
. We consider a policy to be in force when we have issued a member his or her insurance policy or discount benefit plan and have collected the applicable premium payments, commissions, and/or discount benefit fees. Our policies in force are an important indicator of our expected revenues. A member may be enrolled in more than one policy or discount benefit plan simultaneously. A plan becomes inactive upon notification to us of termination of the policy or discount benefit plan, when the member’s policy or discount benefit plan expires or following non-payment of premiums or discount benefit fees when due.
The following table presents the number of policies in force by product type as of
December 31, 2017
and
2016
:
|
|
|
|
|
|
|
|
|
|
|
As of December 31,
|
|
|
|
2017
|
|
2016
|
|
Change
|
IFP
|
179,302
|
|
|
133,568
|
|
|
34.2
|
%
|
Supplemental products
|
196,754
|
|
|
156,549
|
|
|
25.7
|
%
|
Total
|
376,056
|
|
|
290,117
|
|
|
29.6
|
%
|
EBITDA.
We define this metric as net income before interest, income taxes and depreciation and amortization. We have included EBITDA in this report because it is a key measure used by our management and board of directors to understand and evaluate our core operating performance and trends, to prepare and approve our annual budget and to develop short- and long-term operational plans. In particular, the exclusion of certain expenses in calculating EBITDA can provide a useful measure for period-to-period comparisons of our business. However, EBITDA does not represent, and should not be considered as, an alternative to net income or cash flows from operations, each as determined in accordance with GAAP. Other companies may calculate EBITDA differently than we do. EBITDA has limitations as an analytical tool, and you should not consider it in isolation or as a substitute for analysis of our results as reported under GAAP.
Adjusted EBITDA
. To calculate adjusted EBITDA, we calculate EBITDA, which is then further adjusted for items that are not part of regular operating activities, including transaction costs, tax receivable agreement liability adjustment, severance, restructuring costs, and other non-cash items such as non-cash stock-based compensation. Adjusted EBITDA does not represent, and should not be considered as, an alternative to net income or cash flows from operations, each as determined in accordance with GAAP. We have presented adjusted EBITDA because we consider it an important supplemental measure of our performance and believe that it is frequently used by analysts, investors and other interested parties in the evaluation of companies. Other companies may calculate adjusted EBITDA differently than we do. Adjusted EBITDA has limitations as an analytical tool, and you should not consider it in isolation or as a substitute for analysis of our results as reported under GAAP.
The following table presents a reconciliation of net income to EBITDA and adjusted EBITDA for the years ended
December 31, 2017
and
2016
($ in thousands):
|
|
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
|
2017
|
|
2016
|
Net income
|
|
$
|
26,491
|
|
|
$
|
13,109
|
|
Interest (income) expense
|
|
(19
|
)
|
|
61
|
|
Depreciation and amortization
|
|
4,044
|
|
|
3,249
|
|
Provision (benefit) for income taxes
|
|
16,818
|
|
|
(4,751
|
)
|
EBITDA
|
|
47,334
|
|
|
11,668
|
|
Non-cash stock-based compensation
|
|
7,404
|
|
|
3,792
|
|
Fair value adjustment to contingent consideration
|
|
—
|
|
|
15
|
|
Transaction costs
|
|
745
|
|
|
—
|
|
Tax receivable agreement liability adjustment
|
|
(11,835
|
)
|
|
9,678
|
|
Severance, restructuring and other
|
|
1,805
|
|
|
2,609
|
|
Adjusted EBITDA
|
|
$
|
45,453
|
|
|
$
|
27,762
|
|
Adjusted net income.
To calculate adjusted net income, we calculate net income then add back amortization (but not depreciation), interest, tax expense and other items that are not part of regular operating activities, including transaction costs, tax receivable agreement liability adjustment, severance, restructuring costs, and other non-cash items such as non-cash stock-based compensation. From adjusted pre-tax net income we apply a pro forma tax expense calculated at an assumed rate of 38% which consists of the maximum federal corporate rate of 35% with an assumed 3% state tax rate. We believe that when measuring Company and executive performance against the adjusted net income measure, applying a pro forma tax rate better reflects the performance of the Company without regard to the Company’s organizational tax structure. We have included adjusted net income in this report because it is a key performance measure used by our management to understand and evaluate our core operating performance and trends and because we believe it is frequently used by analysts, investors and other interested parties in their evaluation of the Company. Other companies may calculate this measure differently than we do. Adjusted net income has limitations as an analytical tool, and you should not consider it in isolation or substitution for earnings per share as reported under GAAP.
Adjusted net income per share.
Adjusted net income per share is computed by dividing adjusted net income by the total number of weighted-average diluted Class A and weighted-average Class B shares of our common stock for each period. We have included adjusted net income per share in this report because it is a key measure used by our management to understand and evaluate our core operating performance and trends and because we believe it is frequently used by analysts, investors and other interested parties in the evaluation of companies. Other companies may calculate this measure differently than we do. Adjusted net income per share has limitations as an analytical tool, and you should not consider it in isolation or as a substitute for earnings per share as reported under GAAP.
The following table presents a reconciliation of net income to adjusted net income and adjusted net income per share for the years ended
December 31, 2017
and
2016
(in thousands, except per share data):
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Net income
|
$
|
26,491
|
|
|
$
|
13,109
|
|
Interest (income) expense
|
(19
|
)
|
|
61
|
|
Amortization
|
1,965
|
|
|
2,154
|
|
Provision (benefit) for income taxes
|
16,818
|
|
|
(4,751
|
)
|
Non-cash stock-based compensation
|
7,404
|
|
|
3,792
|
|
Fair value adjustment to contingent consideration
|
—
|
|
|
15
|
|
Transaction costs
|
745
|
|
|
—
|
|
Tax receivable agreement liability adjustment
|
(11,835
|
)
|
|
9,678
|
|
Severance, restructuring and other charges
|
1,805
|
|
|
2,609
|
|
Adjusted pre-tax income
|
43,374
|
|
|
26,667
|
|
Pro forma income taxes
|
(16,482
|
)
|
|
(10,133
|
)
|
Adjusted net income
|
$
|
26,892
|
|
|
$
|
16,534
|
|
Total weighted average diluted share count (1)
|
16,322
|
|
|
14,751
|
|
Adjusted net income per share
|
$
|
1.65
|
|
|
$
|
1.12
|
|
(1) The year-over-year increase in non-GAAP weighted average diluted share count was driven by the increase in issued shares relating to stock appreciation rights exercises described in Note 8 of the accompanying consolidated financial statements.
Core SG&A.
We define this metric as total GAAP selling, general, and administrative ("SG&A") expenses adjusted for stock-based compensation, severance, restructuring and other costs, and marketing leads and advertising expense. We have included Core SG&A in this report because it is a key measure used by our management to understand and evaluate our core operating performance and trends. Other companies may calculate this measure differently than we do. Core SG&A has limitations as an analytical tool, and you should not consider it in isolation or as a substitute for SG&A as reported under GAAP.
The following table presents a reconciliation of SG&A to Core SG&A for the years ended
December 31, 2017
and
2016
($ in thousands):
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Total SG&A
|
$
|
64,446
|
|
|
$
|
51,527
|
|
Less Stock-based compensation
|
7,404
|
|
|
3,792
|
|
Less Transaction Cost
|
745
|
|
|
—
|
|
Less Severance, restructuring and other charges
|
1,805
|
|
|
2,609
|
|
Less Marketing and Advertising
|
11,454
|
|
|
11,063
|
|
Core SG&A
|
$
|
43,038
|
|
|
$
|
34,063
|
|
% of Revenue
|
17.2
|
%
|
|
18.5
|
%
|
Results of Operations
Revenues
Our revenues primarily consist of commissions and fees earned for health insurance policies and supplemental products issued to members, referral fees, and fees for discount benefit plans paid by members as a direct result of our enrollment services, brokerage services or referral sales. Revenues reported by the Company are net of risk premiums remitted to insurance carriers and fees paid for discount benefit plans.
Commission rates for our products are agreed to in advance with the relevant insurance carrier and vary by carrier and policy type. Under our carrier compensation arrangements, the commission rate schedule that is in effect on the policy effective date governs the commissions over the life of the policy. All amounts due to insurance carriers and discount benefit vendors are reported and paid to them according to the procedures provided for in the contractual agreements between the individual carrier or vendor and us.
We continue to receive a commission payment until the plan expires or is terminated. Accordingly, a significant portion of our monthly revenues is predictable on a month-to-month basis and revenues increase in direct proportion to the growth we experience in the number of policies in force.
Revenues for the year ended
December 31, 2017
were
$250.5 million
, an increase of
$66.0 million
, or
35.7%
, compared to
2016
. The increases were primarily due to a
29.6%
year over year growth, in the number of policies in force, to
376,056
at
December 31, 2017
from
290,117
at
December 31, 2016
. The increase in revenues was driven by an increase in policies in force, favorable commission margins, and improved discount benefit plan offerings.
Third-party Commissions
Our third-party commissions consist of fees and commissions paid to third-party distributors for selling our products to members, which we pay monthly for existing members and on a weekly basis for new members. Third-party commissions, as a percentage of revenue, will vary based on the mix of sales between AgileHealthInsurance.com and our third-party distributors.
Third-party commissions for the year ended
December 31, 2017
were
$145.3 million
, an increase of
$37.6 million
, or
35.0%
, compared to
2016
. The increases in third-party commissions were primarily due to an increase in the number of policies in force sold through third-party independent distributors.
Third-party commissions represented
58.0%
and
36.7%
of revenues and premium equivalents, respectively, for the year ended
December 31, 2017
, as compared to
58.4%
and
34.6%
of revenues and premium equivalents for
2016
. These changes were largely the result of increased incentives provided to several third-party distributors during the year. Third-party commission increases were partially off-set by lower effective commission rates for distributors with advanced commission balances.
Credit Card and ACH Fees
Our credit card and ACH fees are fees paid to our banks and processors for the collection of credit card and ACH payments. We expect credit card and ACH fees as a percentage of revenue to remain generally consistent with prior periods.
Credit card and ACH fees for the year ended
December 31, 2017
were
$5.1 million
, an increase of
$1.2 million
, or
29.5%
, compared to
2016
. The increase in credit card and ACH fees was in line with the increase in premium equivalents.
Credit card and ACH fees represented
2.0%
and
1.3%
of revenues and premium equivalents, respectively, for the year ended
December 31, 2017
, compared to
2.1%
and
1.2%
of revenues and premium equivalents, respectively, in
2016
. These percentages are in line with our expectations.
Selling, General and Administrative Expense
Our SG&A expenses primarily consist of personnel costs, which include salaries, bonuses, commissions, stock-based compensation, payroll taxes and benefits. SG&A expenses also include selling and marketing expenses and travel costs associated with obtaining new distributor relationships. In addition, these expenses also include expenses for outside professional services and technology expenses, including legal, audit and financial services and the maintenance of our administrative technology platform and marketing costs for online advertising.
SG&A expense for the year ended
December 31, 2017
was
$64.4 million
. This represents an increase of
$12.9 million
, or
25.1%
, for the year ended
December 31, 2017
compared to
2016
.
SG&A expense represented
25.7%
and
16.3%
of revenues and premium equivalents, respectively, for the year ended
December 31, 2017
compared to
27.9%
and
16.5%
of revenues and premium equivalents, respectively, for
2016
.
The decrease in SG&A expenses as a percentage of revenues for the year ended
December 31, 2017
compared to the same period
2016
was primarily attributable to increasing revenues from growth in policies-in-force and efficiencies gained from our scalable technology platform.
Depreciation and Amortization
Depreciation and amortization expense is primarily related to the amortization of acquired intangible assets as well as depreciation of property and equipment used in our business.
Depreciation and amortization expenses for
2017
were
$4.0 million
, an increase of
$795,000
or
24.5%
, compared to
2016
. The increase in depreciation and amortization was primarily driven by depreciation of internal-use software.
Federal Income Tax Reform
On December 22, 2017, prior to the end of the Company’s fiscal year, the President of the United States signed into law H.R. 1, referred to as the “Tax Act.” The Securities and Exchange Commission (“SEC”) issued Staff Accounting Bulletin No. 118 (“SAB 118”) on December 22, 2017. SAB 118 provides up to a one-year measurement period from a registrant’s reporting period that includes the Tax Act’s enactment date to allow the registrant sufficient time to obtain, prepare and analyze information to complete the accounting required under ASC 740.
The reduction of the U.S. federal tax rate from 35% to 21% resulted in tax expense of
$12.6 million
due to the re-measurement of our deferred tax assets. The reduction of the federal tax rate also resulted in a one-time increase to income of
$11.8 million
due to the reduction of the Tax Receivable Agreement ("TRA") liability. The overall net impact impact of these amounts reduced earnings by
$775,000
. The reduction in the tax rate will also impact the company’s tax expense in future periods beginning in 2018.
The Company is evaluating the other provisions of the Act and does not believe that the other provisions will have a material impact on the consolidated financial statements, if any.
Tax Receivable Agreement (Income) Expense
For the year ended
December 31, 2017
, there was
$11.8 million
of income recorded under the TRA as a result of recent changes in the Tax Act. Conversely, TRA expense for the year ended December 31, 2016 was
$9.7 million
, primarily due to our revised estimate of the probability of such future payments. See Note 12 of the accompanying consolidated financial statements for further information on the TRA with the holders of HPIH Series B Membership Interests
.
Other Expense
Other expense was
$104,000
for the year ended
December 31, 2017
and was comprised of approximately
$48,000
of miscellaneous state tax expense other than income taxes, and approximately
$56,000
in miscellaneous bank fees. For the year ended
December 31, 2016
, other expense was
$5,000
from miscellaneous bank fees.
Provision (Benefit) for Income Taxes
For
2017
, we recorded a provision for income tax expense of
$16.8 million
, reflecting an effective tax rate of
38.8%
. For
2016
, we recorded a benefit for income taxes of
$4.8 million
, reflecting an effective tax rate of
(56.8)%
. During 2016, the effective tax rate was significantly impacted by release of the valuation allowance provided against much of our deferred tax assets. The deferred tax asset is a result of obligations under the TRA. We recorded and maintained a full valuation allowance on all of the related deferred tax assets of HIIQ until December 31, 2016 when there was sufficient evidence to support a partial reversal. The reversal of the valuation allowance resulted in the recognition of $8.1 million of deferred tax assets at December 31, 2016. See Note 9 of the accompanying audited financial statements for further information on income taxes and the effective tax rates.
Noncontrolling Interest
We are the sole managing member of HPIH and have 100% of the voting rights and control. As of
December 31, 2017
, we had a
76.3%
economic interest in HPIH, whereas HPI and HPIS collectively held the remaining
23.7%
economic interest in HPIH. HPI and HPIS’s interest in HPIH is reflected as a noncontrolling interest on our accompanying consolidated financial statements contained elsewhere in this report.
Net income attributable to HIIQ for
2017
and
2016
included HIIQ’s share of its consolidated entities’ net income and loss. See Note 12 of the accompanying consolidated financial statements for further discussion on the TRA with the holders of HPIH Series B Membership Interests.
Liquidity and Capital Resources
General
As of
December 31, 2017
, we had
$39.3 million
of cash and cash equivalents, excluding restricted cash.
We believe that our available cash and cash flows expected to be generated from operations will be adequate to satisfy our current and planned operations for at least the next 12 months, although we can give no assurances concerning future liquidity.
Our Indebtedness
On July 17, 2017, the Company, through HPIH, entered into a Credit Agreement (the “Credit Agreement”) among HPIH, and certain of its affiliates as guarantors, and SunTrust Bank, as lender (the “Lender”). The Credit Agreement provides for a $30.0 million revolving credit facility (the “Credit Facility”) pursuant to which the Lender has agreed to make revolving loans and issue letters of credit. The Credit Facility will be used for general corporate purposes, including funding of ongoing working capital needs, capital expenditures, and permitted acquisitions. The Credit Facility also provides HPIH with the right to request additional incremental term loans thereunder up to an aggregate additional amount of $20.0 million, subject to the satisfaction of certain additional conditions provided therein.
The Credit Facility matures on July 17, 2020 (the “Termination Date”) and borrowings under the Credit Agreement can either be, at HPIH’s election: (i) at the Base Rate (which is the highest of the prime rate, the federal funds rate plus 0.50%, the one-month LIBOR index rate plus 1.00%, and zero) plus a spread ranging from 0.75% to 1.25% or (ii) at Adjusted LIBOR (as defined in the Credit Agreement) plus a spread ranging from 1.75% to 2.25%. The applicable spread is dependent upon HPIH’s Consolidated Total Leverage Ratio (as defined in the Credit Agreement). Interest accrued on each Base Rate Loan (as defined in the Credit Agreement) is payable in arrears on the last day of each calendar quarter and on the Termination Date. Interest accrued on each Eurodollar Loan (as defined in the Credit Agreement) is payable on the last day of the applicable interest period, or every three months, whichever comes sooner, and on the Termination Date.
The Credit Facility is secured by: (i) a first priority lien on substantially all of the assets (subject to certain excluded assets) of HPIH and certain of its affiliates (including the Company) and (ii) pledges of equity interests in the subsidiaries of the Company.
The Credit Agreement contains customary covenants including, but not limited to, (i) a minimum interest coverage ratio and a maximum Consolidated Total Leverage Ratio and (ii) limitations on incurrence of debt, investments, liens on assets, certain sale and leaseback transactions, transactions with affiliates, mergers, consolidations and sales of assets. The Credit Agreement also includes customary events of default, conditions, representations and warranties, and indemnification provisions.
As of December 31, 2017, we had no outstanding balance from draws on the Credit Facility and
$30.0 million
was available to be drawn upon. Concurrent with the execution of the above Credit Agreement, the Company terminated its previous revolving line of credit established on December 15, 2014. As of December 31, 2016 we had no outstanding balance from draws on the previous revolving line of credit.
Registration
Statement on Form S-3
On May 5, 2017, the Company filed a registration statement on Form S-3, which was declared effective by the SEC on May 19, 2017, to offer and sell, from time to time, up to $150.0 million of any combination of debt securities, Class A Common Stock, preferred stock, warrants, subscription rights, units, or purchase contracts as described in the related prospectus. Securities may be sold in one or more classes or series and in amounts, at prices and on terms that we will determine at the times of the offerings and we may offer the securities independently or together in any combination for sale directly to purchasers or through underwriters,
dealers or agents to be designated at a future date. We intend to use the net proceeds from the sale of the securities for general corporate purposes, including potentially expanding existing businesses, acquiring businesses and investing in other business opportunities. At
December 31, 2017
the Company had not sold any securities under this Registration Statement.
Cash Flows
The following summary of cash flows for the periods indicated has been derived from our financial statements included elsewhere in this report.
Cash Flows from Operating Activities
Cash provided by operating activities for the year ended
December 31, 2017
of
$41.9 million
was primarily the result of consolidated net income, before noncontrolling interests, of
$26.5 million
. Adjustments to reconcile net income to net cash provided by operating activities consisted of
$4.0 million
of depreciation and amortization,
$7.4 million
of stock-based compensation, and a
$14.0 million
increase in deferred tax assets, of which
$12.6 million
was the result of the change in corporate tax rate due to the Tax Act. The primary drivers of the net change in operating liabilities were an increase in accounts payable, accrued expenses and other liabilities of
$9.9 million
, and decreases in income taxes payable of
$1.3 million
, and due to member of
$12.4 million
,
$11.8 million
of which related to the decreased corporate tax rate due to the Tax Act. This was offset by an increase in restricted cash of
$3.0 million
and an increase in advanced commissions of
$2.5 million
. The increase in advanced commissions was the result of increased sales by our third-party distributors, driven by continued demand for our affordable healthcare products.
Cash provided by operating activities for the year ended
December 31, 2016
of
$18.0 million
was primarily the result of consolidated net income, before noncontrolling interests, of
$13.1 million
. Adjustments to reconcile net income to net cash provided by operating activities consisted of
$3.2 million
of depreciation and amortization, and
$3.8 million
of stock-based compensation. The primary drivers of the net change in operating assets and liabilities were a
$12.5 million
increase in advanced commissions to our distributors, an increase in accounts payable, accrued expenses and other liabilities by
$12.0 million
, and an increase in due to member of
$9.2 million
. These were offset by an increase in restricted cash of
$4.0 million
and a decrease in accounts receivable, prepaid expenses and other current assets of
$1.1 million
. The increase in advanced commissions was the result of increased sales by our third-party distributors, driven by continued demand for our affordable healthcare products. The
$9.2 million
increase in due to member was the impact of recording the corresponding TRA liability associated with the release of the valuation allowance against our deferred tax assets.
Cash Flows from Investing Activities
Our uses of cash in investing activities for the year ended
December 31, 2017
included cash used to fund the development of internal-use software of
$3.0 million
and
$509,000
to purchase property and equipment.
Our uses of cash in investing activities for the year ended
December 31, 2016
of included cash used to fund the development of internal-use software of
$3.1 million
and
$61,000
to purchase property and equipment.
Cash Flows from Financing Activities
During the year ended
December 31, 2017
, cash used in financing activities of $
11.3 million
was primarily attributable to distributions made to members for tax payments under the operating agreement with HPIH for
$5.5 million
, and share repurchases of class A common stock for
$4.9 million
. Common stock withheld in treasury from the vesting of restricted shares accounted for
$842,000
. See Note 14 of the accompanying consolidated financial statements for information on the operating agreement between HPIH and its members.
During the year ended
December 31, 2016
, cash used in financing activities of
$10.4 million
was primarily attributable to proceeds received from borrowings under the revolving line of credit of
$7.5 million
offset by repayments on the line of
$15.0 million
, distributions to members for tax payments under the operating agreement of HPIH of
$2.0 million
, payments of
$547,000
under contingent consideration obligations, and payments on noncompete agreements of
$192,000
.
Off-Balance Sheet Arrangements
Through
December 31, 2017
, we had not entered into any off-balance sheet arrangements, other than the operating leases discussed in Note 12 of the accompanying consolidated financial statements.
Critical Accounting Policies and Estimates
Our significant accounting policies are outlined in Note 1 to the consolidated financial statements included in this Form 10-K. Our financial statements are prepared in accordance with GAAP. The preparation of these financial statements requires our management to make estimates, assumptions and judgments that affect the reported amounts of assets and liabilities and disclosure of contingent assets and liabilities at the date of the financial statements, and the reported amounts of revenues and expenses during the applicable periods. We base our estimates, assumptions and judgments on historical experience and on various other factors that we believe to be reasonable under the circumstances. Different assumptions and judgments could change the estimates used in the preparation of our financial statements, which, in turn, could change the results from those reported. We evaluate our estimates, assumptions and judgments on an ongoing basis. The critical accounting estimates, assumptions and judgments that we believe have the most significant impact on our financial statements are described below. We have elected under the JOBS Act to delay adoption of new or revised accounting pronouncements applicable to public companies until such pronouncements are made applicable to private companies. As a result of this election, our financial statements may not be comparable to companies that comply with public company effective dates.
Impairment of Goodwill
Methodology
We evaluate goodwill, which had a carrying value of
$41.1 million
as of
December 31, 2017
, for impairment at least annually, during the fourth quarter of each year, or whenever events or changes in circumstances indicate that the carrying amount of such assets may not be recoverable. To assess the realizability of goodwill, we have the option to first assess qualitative factors to determine whether the existence of events or circumstances leads to a determination that it is more likely than not that the fair value of a reporting unit is less than its carrying amount. We may elect to forgo this option and proceed to the annual two-step goodwill impairment test.
If we elect to perform the qualitative assessment and it indicates that a significant decline to fair value of a reporting unit is more likely than not, or if a reporting unit’s fair value has historically been closer to its carrying value, or we elect to forgo this qualitative assessment, we will proceed to Step 1 testing where we calculate the fair value of a reporting unit based on discounted future probability-weighted cash flows. If Step 1 indicates that the carrying value of a reporting unit is in excess of its fair value, we will proceed to Step 2 where the fair value of the reporting unit will be allocated to assets and liabilities as it would in a business combination. Impairment occurs when the carrying amount of goodwill exceeds its estimated fair value calculated in Step 2.
Judgments and Uncertainties
A qualitative assessment will require judgments involving relevant factors, including but not limited to, changes in the general economic environment, industry and regulatory considerations, current economic performance compared to historical economic performance and other relevant company-specific events such as changes in management, key personnel or business strategy, where applicable.
While performing the reporting unit’s impairment assessment we use, or have used, a combination of valuation approaches including the market approach and the income approach. The market approach uses a guideline company methodology, which is based upon a comparison of the reporting unit to similar publicly-traded companies within our industry. We derive a market value of invested capital or business enterprise value for each comparable company by multiplying the price per share of common stock of the publicly traded companies by their total common shares outstanding and adding each company’s current level of debt. We calculate a business enterprise multiple based on revenue and earnings from each company, then apply those multiples to our revenue and earnings to calculate a business enterprise value. Assumptions regarding the selection of comparable companies are made based on, among other factors, capital structure, operating environment and industry. As the comparable companies were typically larger and more diversified than our business, multiples were adjusted prior to application to our revenues and earnings to reflect differences in margins, long-term growth prospects and market capitalization.
The most significant assumptions used in these analyses are those made in estimating future cash flows. In estimating future cash flows, the income approach uses a discounted debt-free cash flow analysis to measure fair value by estimating the present value of future economic benefits. To perform the discounted debt-free cash flow analysis, we develop a pro forma analysis of the reporting unit to estimate future available debt-free cash flow and discounting estimated debt-free cash flow by an estimated industry weighted average cost of capital based on the same comparable companies used in the market approach. Per FASB guidance, the weighted average cost of capital is based on inputs (e.g., capital structure, risk, etc.) from a market participant’s perspective and not necessarily from the reporting unit’s perspective.
Future cash flow is projected based on assumptions for our economic growth, industry expansion, future operations and the discount rate, all of which require significant judgments by management.
Effect If Actual Results Differ From Assumptions
We establish our assumptions and arrive at the estimates used in these calculations based upon our historical experience, knowledge of our industry and by incorporating third-party data, which we believe results in a reasonably accurate approximation of fair value. Nevertheless, changes in the assumptions used could have an impact on our assessment of recoverability. We believe our projected sales are reasonable based on, among other things, available information regarding our industry. We also believe the discount rate is appropriate. The weighted average discount rate is impacted by current financial market trends and will remain dependent on such trends in the future.
If actual results differ substantially from the assumptions used in performing the impairment test, the fair value of the reporting units may be significantly lower, causing the carrying value to exceed the fair value and indicating an impairment has occurred. Absent offsetting changes in other factors, a 1% increase in the discount rate would decrease the estimated fair value of our reporting unit by approximately
$11.0 million
, but would not indicate impairment.
Allowance for sales returns
Methodology
The allowance for sales returns represents management’s best estimate of probable returns of policies sold. This estimate is based on a rolling 12 month average of returns tracked by month of service and month of return. In an effort to identify adverse trends for sales returns and chargebacks, we perform ongoing reviews of returns. In the prior year, management applied an "open enrollment" factor to the model, however review of actual returns compared to those estimated in 2016 resulted in revisions to the model such that this factor was deemed unnecessary. Revision of these assumptions resulted in a overall lower allowance as a percentage of sales.
Judgments and Uncertainties
Historical sales returns may not be an accurate representation of current sales return trends. Management monitors these returns regularly to identify trends however additional factors that impact sales returns may not be included within the analysis which could materially impact the net reported revenues.
Effect If Actual Results Differ From Assumptions
As of
December 31, 2017
and
2016
, our allowance accounts were
$471,000
and
$695,000
, respectively. As a measure of sensitivity, a 1% change in the allowance calculation would have a
$90,000
and
$313,000
net effect on pre-tax earnings, respectively.
Advanced commissions allowance
Methodology
The allowance for advanced commissions represents management’s best estimate of probable losses inherent in the receivable balance. These estimates are based on a multiple calculation of expected payback period relative to term length of policy sold. In an effort to identify adverse trends for advanced commissions, we perform ongoing reviews of tranche level account balances and their respective payback period. The recovery of advanced commission balances are evaluated on an account-by-account basis.
Judgments and Uncertainties
Write-offs are charged against the allowance account only after we have exhausted all collection efforts. Actual write-offs and adjustments could differ from the allowance estimates due to unanticipated changes in the business environment as well as factors and risks associated with specific distributors.
Effect If Actual Results Differ From Assumptions
As of
December 31, 2017
and
2016
, our allowance accounts were
$180,000
and
$454,000
, respectively. There were no receivable balances written off in
2017
or
2016
.
Currently, we do not believe that we have a significant amount of risk relative to the allowance for advanced commissions. As a measure of sensitivity, a
10%
change in the allowance would have a
$18,000
and
$45,000
in
2017
and
2016
, respectively, effect on pre-tax earnings.
Deferred tax asset and amounts due to member pursuant to the TRA agreement
Methodology
We evaluate quarterly the positive and negative evidence regarding the expected realization of net deferred tax assets. The carrying value of our net deferred tax assets is based on our assessment as to whether it is more likely than not that we will generate sufficient future taxable income to realize these deferred tax assets. We maintained a full valuation allowance on all of deferred tax assets of HIIQ until December 31, 2016 when there was sufficient evidence to support the reversal of the eligible allowance.
Judgments and Uncertainties
Significant management judgment is required in determining the period in which the reversal of a valuation allowance should occur. We considered all available evidence, both positive and negative, such as historical levels of income and future forecasts of taxable income, among other items, in determining whether a full or partial release of the valuation allowance was required. In addition, our assessments required us to schedule future taxable income in accordance with the applicable tax accounting guidance to assess the appropriateness of a valuation allowance which further required the exercise of significant management judgment.
Effect If Actual Results Differ From Assumptions
When we determined that we would be able to realize certain deferred income tax assets in the foreseeable future, a release of all of the related eligible valuation allowance resulted in the recognition of $8.1 million of deferred tax assets at December 31, 2016 and a reduction of income tax expense of $8.1 million. The release of the valuation allowance resulted in the recognition of a $9.1 million tax receivable agreement obligation and $9.1 million in TRA expense which is in TRA expense in the 2016 consolidated statement of income. In 2017, due to the impact of the change in corporate tax rate related to the Tax Act, we recognized an increase of $11.8 million in the tax receivable agreement obligation, and a corresponding increase to non-operating TRA income of $11.8 million. Income tax expense increased by $12.5 million while the deferred tax asset, net decreased by $12.9 million.
If actual future Company earnings are materially less than forecasted or if other underlying assumptions differ materially, the Company may not have adequate future taxable income to realize the entirety of the recorded deferred tax assets.
Stock-based compensation
Methodology
Expense for stock-based compensation is recognized based upon estimated grant date fair value and is amortized over the service period of the awards using the accelerated method. We offer awards which vest based on service conditions, performance conditions or market conditions. For grants of stock appreciation rights and stock options, we apply the Black-Scholes option-pricing model, Monte Carlo Simulation, or a lattice model, depending on the vesting conditions, in determining the fair value of share-based payments to employees.
The resulting compensation expense is recognized over the requisite service period. The requisite service period is the period during which an employee is required to provide service in exchange for an award, which often is the vesting period. Compensation expense is recognized only for those awards expected to vest. In accordance with GAAP, compensation expense is not recognized for awards with performance vesting conditions until it is deemed probable that the underlying performance events will occur. All stock-based compensation expense is classified within SG&A expense in the consolidated statements of income.
Judgments and Uncertainties
The models used incorporate various assumptions, including expected volatility and expected term. Volatility is calculated using the Company’s trading history. The expected term of awards granted is based on the Company’s best estimate and the use of the simplified method for “plain vanilla” awards under GAAP, where applicable. Accruals of compensation cost for an award with a performance condition shall be based on the probable outcome of that performance condition. Therefore, compensation cost shall be accrued if it is probable that the performance condition will be achieved and shall not be accrued if it is not probable that the performance condition will be achieved. Such judgments can significantly impact the timing and amount of expense recognized.
Effect If Actual Results Differ From Assumptions
As a measure of sensitivity, a 1% change to our estimated forfeiture rate would have had an approximate
$98,000
impact on our
2017
operating income compared to
$15,000
in
2016
. Our estimated forfeiture rates as of
December 31, 2017
and
2016
, were
7%
. We do not believe there is a reasonable likelihood that there will be a material change in the future estimates or assumptions we use to determine stock-based compensation expense.
Loss contingencies
Methodology
We are involved in various lawsuits, claims, investigations, and proceedings that arise in the ordinary course of business. Certain of these matters include speculative claims for substantial or indeterminate amounts of damages. We record a liability when we believe that it is both probable that a loss has been incurred and the amount can be reasonably estimated.
Judgments and Uncertainties
Significant judgment is required to determine both probability and the estimated amount. We review these provisions at least quarterly and adjust these provisions accordingly to reflect the impact of negotiations, settlements, rulings, updates from legal counsel, and other updated information.
Effect If Actual Results Differ From Assumptions
We believe that the amount or estimable range of reasonably possible loss, will not, either individually or in the aggregate, have a material adverse effect on our business or consolidated financial statements with respect to loss contingencies for legal and other contingencies as of
December 31, 2017
. However, the outcome of litigation is inherently uncertain. Therefore, if one or more of these legal matters were resolved against us for amounts in excess of management’s expectations, our results of operations and financial condition, including in a particular reporting period, could be materially adversely affected.
Recent Accounting Pronouncements
Note 1 to the consolidated financial statements contains a summary of the Company’s significant accounting policies, including a discussion of recently issued accounting pronouncements and their impact or potential future impact on the Company’s financial results, if determinable, under the sub-heading “Recent Accounting Pronouncements.”
Carrier Concentration
For the year ended
December 31, 2017
, three carriers accounted for
54%
of our premium equivalents compared to the three carriers who accounted for
60%
of our premium equivalents at
December 31, 2016
. The Company anticipates that its premium equivalents in
2018
will continue to be concentrated among a small number of carriers, although as a part of the Company’s strategy of improving and increasing its product mix by seeking to add innovative new products, the Company anticipates that its carrier concentration may decrease. See Note 15 "Concentrations of Credit Risk and Significant Customers" of the accompanying consolidated financial statements for further information.
Legal and Other Contingencies
The Company is subject to legal proceedings, claims, and liabilities that arise in the ordinary course of business. Regardless of the outcome, litigation can have an adverse impact on us because of defense and settlement costs, diversion of management resources and other factors. The Company accrues losses associated with legal claims when such losses are probable and reasonably
estimable. If the Company determines that a loss is probable and cannot estimate a specific amount for that loss, but can estimate a range of loss, the best estimate within the range is accrued. If no amount within the range is a better estimate than any other, the minimum amount of the range is accrued. Estimates are adjusted as additional information becomes available or circumstances change. Legal defense costs associated with loss contingencies are expensed in the period incurred. For detailed discussion surrounding legal and other contingencies, see Note 12 in the accompanying consolidated financial statements.
ITEM 7A. QUANTITATIVE AND QUALITATIVE DISCLOSURES ABOUT MARKET RISK
Pursuant to Rule 12b-2 and SEC Release No. 33-8876, a smaller reporting company transitioning to the larger reporting company system, is not required to satisfy a larger reporting company's reporting requirements until the first quarterly report on Form 10-Q for the following fiscal year. Under the disclosure requirements for a smaller reporting company, this information is not required to be provided.
ITEM 8. FINANCIAL STATEMENTS AND SUPPLEMENTARY DATA
Financial statements and exhibits filed under this item are listed in the index appearing in Part IV, Item 15 of this report.
ITEM 9. CHANGES IN AND DISAGREEMENTS WITH ACCOUNTANTS ON ACCOUNTING AND FINANCIAL DISCLOSURE
None.
ITEM 9A. CONTROLS AND PROCEDURES
Evaluation of Disclosure Controls and Procedures
The Company’s management has evaluated, under the supervision of the Company’s principal executive officer and principal financial officer, the effectiveness of its disclosure controls and procedures as defined in Rules 13a-15(e) and 15d-15(e) under the Exchange Act.
Based on this evaluation as of
December 31, 2017
, the Company’s principal executive officer and principal financial officer concluded that the design and operation of the Company’s disclosure controls and procedures were effective as of
December 31, 2017
to ensure that information required to be disclosed by us in reports that we file or submit under the Exchange Act is (i) recorded, processed, summarized and reported within the time periods specified in SEC rules and forms, and (ii) accumulated and communicated to management, including our principal executive officer and principal financial officer, as appropriate to allow timely decisions regarding required disclosure. In designing and evaluating the disclosure controls and procedures, management recognizes that any controls and procedures, no matter how well designed and operated, can provide only reasonable assurance of achieving the desired control objectives.
Management’s Report on Internal Control over Financial Reporting
The Company’s management, under the supervision of the Company’s principal executive officer and principal financial officer, is responsible for establishing and maintaining adequate internal control over financial reporting, as defined in Rules 13a-15(f) and 15d-15(f) under the Exchange Act. The Company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with GAAP. Internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the Company, (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with GAAP, and that receipts and expenditures of the Company are being made only in accordance with authorizations of management and directors of the Company and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the Company’s assets that could have a material effect on the financial statements.
The Company’s management has assessed the effectiveness of our internal control over financial reporting as of
December 31, 2017
. In making its assessment of our internal control over financial reporting, management used Internal Control – Integrated Framework issued by the Committee of Sponsoring Organizations of the Treadway Commission (2013 Framework). The Company’s management has concluded that, as of
December 31, 2017
, our internal control over financial reporting was effective.
This report does not include an attestation report of the Company’s independent registered public accounting firm regarding internal control over financial reporting as emerging growth companies are not required to include such report.
Changes in Internal Control over Financial Reporting
There were no changes in the Company’s internal control over financial reporting during the year ended
December 31, 2017
that have materially affected, or are reasonably likely to materially affect, the Company’s internal control over financial reporting.
ITEM 9B. OTHER INFORMATION
None.
PART III
ITEM 10. DIRECTORS, EXECUTIVE OFFICERS AND CORPORATE GOVERNANCE
The information required by this Item is incorporated herein by reference to the information provided under the headings “Election of Directors - Nominees for Election for a One-Year Term Expiring at the
2018
Annual Meeting,” “Corporate Governance,” “Current Executive Officers” and “Section 16(a) Beneficial Ownership Reporting Compliance” in our definitive proxy statement to be filed with the Securities and Exchange Commission not later than 120 days after the fiscal year ended
December 31, 2017
(the “
2018
Proxy Statement”).
We have adopted a Code of Business Conduct and Ethics, which is applicable to all of our directors, employees and officers, including our principal executive officer, principal financial officer and principal accounting officer. A copy of the Code of Business Conduct and Ethics can be found at our website at www.hiiquote.com. Any amendments to or waivers from the Code of Business Conduct and Ethics will be posted on our website.
ITEM 11. EXECUTIVE COMPENSATION
On February 26, 2018, the Compensation Committee of our Board of Directors approved an additional cash bonus of $650,000 for Gavin D. Southwell (our President and CEO) and $175,000 for Michael D. Hershberger (our CFO) for the 2017 fiscal year in addition to the amounts otherwise payable under the short-term cash bonus program for 2017. All other information required by this Item is incorporated herein by reference to the information provided under the headings “Corporate Governance – Board Meetings and Committees – Compensation Committee,” “Executive Compensation” and “Director Compensation” in the
2018
Proxy Statement.
ITEM 12. SECURITY OWNERSHIP OF CERTAIN BENEFICIAL OWNERS AND MANAGEMENT AND RELATED STOCKHOLDER MATTERS
The information required by this Item is incorporated herein by reference to the information provided under the heading “Security Ownership of Certain Beneficial Owners and Management” in the
2018
Proxy Statement.
ITEM 13. CERTAIN RELATIONSHIPS AND RELATED TRANSACTIONS, AND DIRECTOR INDEPENDENCE
The information required by this Item is incorporated herein by reference to the information provided under the heading “Certain Relationships and Related Party Transactions” in the
2018
Proxy Statement.
ITEM 14. PRINCIPAL ACCOUNTANT FEES AND SERVICES
The information required by this Item is incorporated herein by reference to the information provided under the heading “Fees Paid to Independent Registered Certified Public Accounting Firm in
2017
and
2016
” in the
2018
Proxy Statement.
PART IV
ITEM 15. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES
INDEX TO FINANCIAL STATEMENTS
Health Insurance Innovations, Inc.
|
|
|
|
Page
|
Audited Consolidated Financial Statements
|
|
|
|
|
|
|
|
|
|
|
|
|
|
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
Board of Directors and Shareholders
Health Insurance Innovations, Inc.
Opinion on the financial statements
We have audited the accompanying consolidated balance sheets of Health Insurance Innovations, Inc. (a Delaware corporation) and subsidiaries (the “Company”) as of December 31, 2017 and 2016, the related consolidated statements of income, changes in stockholders’ equity, and cash flows for each of the two years in the period ended December 31, 2017, and the related notes (collectively referred to as the “financial statements”). In our opinion, the financial statements present fairly, in all material respects, the financial position of the Company as of December 31, 2017 and 2016, and the results of its operations and its cash flows for each of the two years in the period ended December 31, 2017, in conformity with accounting principles generally accepted in the United States of America.
Basis for opinion
These financial statements are the responsibility of the Company’s management. Our responsibility is to express an opinion on the Company’s financial statements based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (“PCAOB”) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB.
We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of material misstatement, whether due to error or fraud. The Company is not required to have, nor were we engaged to perform, an audit of its internal control over financial reporting. As part of our audits we are required to obtain an understanding of internal control over financial reporting but not for the purpose of expressing an opinion on the effectiveness of the Company’s internal control over financial reporting. Accordingly, we express no such opinion.
Our audits included performing procedures to assess the risks of material misstatement of the financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the financial statements. We believe that our audits provide a reasonable basis for our opinion.
/s/
GRANT THORNTON LLP
We have served as the Company’s auditor since 2014.
Tampa, Florida
March 1, 2018
HEALTH INSURANCE INNOVATIONS, INC.
Consolidated Balance Sheets
($ in thousands, except share and per share data)
|
|
|
|
|
|
|
|
|
|
December 31,
|
|
2017
|
|
2016
|
Assets
|
|
|
|
|
|
Current assets:
|
|
|
|
|
|
Cash and cash equivalents
|
$
|
39,345
|
|
|
$
|
12,214
|
|
Restricted cash
|
14,920
|
|
|
11,938
|
|
Accounts receivable, net, prepaid expenses and other current assets
|
3,789
|
|
|
2,815
|
|
Advanced commissions, net
|
39,549
|
|
|
37,001
|
|
Total current assets
|
97,603
|
|
|
63,968
|
|
Property and equipment, net
|
5,408
|
|
|
4,022
|
|
Goodwill
|
41,076
|
|
|
41,076
|
|
Intangible assets, net
|
5,942
|
|
|
7,907
|
|
Deferred tax assets, net
|
14,960
|
|
|
8,181
|
|
Other assets
|
96
|
|
|
193
|
|
Total assets
|
$
|
165,085
|
|
|
$
|
125,347
|
|
Liabilities and stockholders’ equity
|
|
|
|
|
|
Current liabilities:
|
|
|
|
|
|
Accounts payable and accrued expenses
|
$
|
39,725
|
|
|
$
|
29,680
|
|
Deferred revenue
|
662
|
|
|
430
|
|
Income taxes payable
|
787
|
|
|
2,121
|
|
Due to member
|
1,775
|
|
|
3,282
|
|
Other current liabilities
|
5
|
|
|
126
|
|
Total current liabilities
|
42,954
|
|
|
35,639
|
|
Due to member
|
15,096
|
|
|
9,460
|
|
Other liabilities
|
34
|
|
|
170
|
|
Total liabilities
|
58,084
|
|
|
45,269
|
|
Commitments and contingencies
|
|
|
|
|
|
Stockholders’ equity:
|
|
|
|
|
|
Class A common stock (par value $0.001 per share, 100,000,000 shares authorized; 12,731,758 and 8,156,249 shares issued as of December 31, 2017 and 2016, respectively; 12,350,981 and 8,036,705 shares outstanding as of December 31, 2017 and 2016, respectively)
|
13
|
|
|
8
|
|
Class B common stock (par value $0.001 per share, 20,000,000 shares authorized; 3,841,667 and 6,841,667 shares issued and outstanding as of December 31, 2017 and 2016, respectively)
|
4
|
|
|
7
|
|
Preferred stock (par value $0.001 per share, 5,000,000 shares authorized; no shares issued and outstanding as of December 31, 2017 and 2016, respectively)
|
—
|
|
|
—
|
|
Additional paid-in capital
|
71,770
|
|
|
47,849
|
|
Treasury stock, at cost (380,777 and 119,544 shares as of December 31, 2017 and 2016, respectively)
|
(6,887
|
)
|
|
(1,122
|
)
|
Retained earnings
|
19,305
|
|
|
1,420
|
|
Total Health Insurance Innovations, Inc. stockholders’ equity
|
84,205
|
|
|
48,162
|
|
Noncontrolling interests
|
22,796
|
|
|
31,916
|
|
Total stockholders’ equity
|
107,001
|
|
|
80,078
|
|
Total liabilities and stockholders’ equity
|
$
|
165,085
|
|
|
$
|
125,347
|
|
The accompanying notes are an integral part of the consolidated financial statements
50
Health Insurance Innovations, Inc.
Consolidated Statements of Income
($ in thousands, except share and per share data)
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Revenues (premium equivalents of $395,552 and $311,590 for the years ended December 31, 2017 and 2016, respectively)
|
$
|
250,476
|
|
|
$
|
184,516
|
|
Operating expenses:
|
|
|
|
|
|
Third-party commissions
|
145,300
|
|
|
107,663
|
|
Credit card and ACH fees
|
5,127
|
|
|
3,960
|
|
Selling, general and administrative
|
64,446
|
|
|
51,527
|
|
Depreciation and amortization
|
4,044
|
|
|
3,249
|
|
Total operating expenses
|
218,917
|
|
|
166,399
|
|
Income from operations
|
31,559
|
|
|
18,117
|
|
|
|
|
|
|
|
Other (income) expense:
|
|
|
|
|
|
Interest (income) expense
|
(19
|
)
|
|
61
|
|
Fair value adjustment to contingent acquisition consideration
|
—
|
|
|
15
|
|
TRA (income) expense
|
(11,835
|
)
|
|
9,678
|
|
Other expense
|
104
|
|
|
5
|
|
Net income before income taxes
|
43,309
|
|
|
8,358
|
|
Provision (benefit) for income taxes
|
16,818
|
|
|
(4,751
|
)
|
Net income
|
26,491
|
|
|
13,109
|
|
Net income attributable to noncontrolling interests
|
8,606
|
|
|
8,596
|
|
Net income attributable to Health Insurance Innovations, Inc.
|
$
|
17,885
|
|
|
$
|
4,513
|
|
|
|
|
|
|
|
Per share data:
|
|
|
|
|
|
Net income per share attributable to Health Insurance Innovations, Inc.
|
|
|
|
|
|
Basic
|
$
|
1.63
|
|
|
$
|
0.59
|
|
Diluted
|
$
|
1.50
|
|
|
$
|
0.57
|
|
Weighted average Class A common shares outstanding
|
|
|
|
|
|
Basic
|
10,970,995
|
|
|
7,599,533
|
|
Diluted
|
11,937,725
|
|
|
7,909,235
|
|
The accompanying notes are an integral part of the consolidated financial statements
51
Health Insurance Innovations, Inc.
Consolidated Statements of Stockholders’ Equity
($ in thousands, except share data)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Insurance Innovations, Inc.
|
|
|
|
|
|
Class A Common Stock
|
|
Class B Common Stock
|
|
|
|
Treasury Stock
|
|
|
|
|
|
|
|
Shares
|
|
Amount
|
|
Shares
|
|
Amount
|
|
Additional Paid-in Capital
|
|
Shares
|
|
Amount
|
|
(Accumulated Deficit) Retained Earnings
|
|
Noncontrolling
Interests
|
|
Stockholders’
Equity
|
Balance as of January 1, 2016
|
7,759,092
|
|
|
$
|
8
|
|
|
6,841,667
|
|
|
$
|
7
|
|
|
$
|
44,591
|
|
|
150,993
|
|
|
$
|
(1,542
|
)
|
|
$
|
(3,093
|
)
|
|
$
|
28,083
|
|
|
$
|
68,054
|
|
Net income
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
4,513
|
|
|
8,596
|
|
|
13,109
|
|
Issuance of Class A common stock under equity compensation plans
|
246,164
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
19
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
19
|
|
Class A common stock withheld in Treasury from restricted share vesting
|
(21,397
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
21,397
|
|
|
(160
|
)
|
|
—
|
|
|
—
|
|
|
(160
|
)
|
Forfeiture of restricted stock held in Treasury
|
(43,600
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
345
|
|
|
43,600
|
|
|
(345
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
Issuances of restricted shares from Treasury
|
75,749
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(721
|
)
|
|
(75,749
|
)
|
|
721
|
|
|
—
|
|
|
—
|
|
|
—
|
|
Issuances of Class A common stock from Treasury
|
20,697
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(183
|
)
|
|
(20,697
|
)
|
|
204
|
|
|
—
|
|
|
—
|
|
|
21
|
|
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
3,792
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
3,792
|
|
Contributions (distributions)
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
6
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(4,763
|
)
|
|
(4,757
|
)
|
Balance as of December 31, 2016
|
8,036,705
|
|
|
$
|
8
|
|
|
6,841,667
|
|
|
$
|
7
|
|
|
$
|
47,849
|
|
|
119,544
|
|
|
$
|
(1,122
|
)
|
|
$
|
1,420
|
|
|
$
|
31,916
|
|
|
$
|
80,078
|
|
Net income
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
17,885
|
|
|
8,606
|
|
|
26,491
|
|
Issuance of Class A common stock in private offering
|
3,000,000
|
|
|
3
|
|
|
—
|
|
|
—
|
|
|
16,484
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
16,487
|
|
Exchange of Series B Membership interest and exchange and cancellation of Class B common stock
|
—
|
|
|
—
|
|
|
(3,000,000
|
)
|
|
(3
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(14,371
|
)
|
|
(14,374
|
)
|
Repurchases of Class A common stock
|
(222,184
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
222,184
|
|
|
(4,923
|
)
|
|
—
|
|
|
—
|
|
|
(4,923
|
)
|
Issuance of Class A common stock under equity compensation plans
|
1,575,509
|
|
|
2
|
|
|
—
|
|
|
—
|
|
|
31
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
33
|
|
Class A common stock withheld in Treasury from restricted share vesting
|
(39,049
|
)
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
39,049
|
|
|
(842
|
)
|
|
—
|
|
|
—
|
|
|
(842
|
)
|
Stock compensation expense
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
7,404
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
7,404
|
|
Contributions (distributions)
|
—
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
2
|
|
|
—
|
|
|
—
|
|
|
—
|
|
|
(3,355
|
)
|
|
(3,353
|
)
|
Balance as of December 31, 2017
|
12,350,981
|
|
|
$
|
13
|
|
|
3,841,667
|
|
|
$
|
4
|
|
|
$
|
71,770
|
|
|
380,777
|
|
|
$
|
(6,887
|
)
|
|
$
|
19,305
|
|
|
$
|
22,796
|
|
|
$
|
107,001
|
|
The accompanying notes are an integral part of the consolidated financial statements
52
Health Insurance Innovations, Inc.
Consolidated Statements of Cash Flows
($ in thousands)
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Operating activities:
|
|
|
|
|
|
Net income
|
$
|
26,491
|
|
|
$
|
13,109
|
|
Adjustments to reconcile net income to net cash provided by operating activities:
|
|
|
|
|
|
Stock-based compensation
|
7,404
|
|
|
3,792
|
|
Depreciation and amortization
|
4,044
|
|
|
3,249
|
|
Fair value adjustments to contingent acquisition consideration
|
—
|
|
|
15
|
|
Deferred income taxes
|
1,343
|
|
|
(8,539
|
)
|
Deferred income taxes related to the Tax Act
|
12,610
|
|
|
0
|
|
Changes in operating assets and liabilities:
|
|
|
|
|
|
Increase in restricted cash
|
(2,982
|
)
|
|
(4,032
|
)
|
Increase in accounts receivable, prepaid expenses and other assets
|
(877
|
)
|
|
(1,088
|
)
|
Increase in advanced commissions
|
(2,548
|
)
|
|
(12,470
|
)
|
Decrease in income taxes receivable
|
—
|
|
|
591
|
|
(Decrease) increase in income taxes payable
|
(1,334
|
)
|
|
2,121
|
|
Increase in accounts payable, accrued expenses and other liabilities
|
9,884
|
|
|
11,960
|
|
Increase in deferred revenue
|
232
|
|
|
46
|
|
(Decrease) increase in due to member pursuant to tax receivable agreement
|
(531
|
)
|
|
9,233
|
|
Decrease in due to member related to the Tax Act
|
(11,835
|
)
|
|
—
|
|
Net cash provided by operating activities
|
41,901
|
|
|
17,987
|
|
Investing activities:
|
|
|
|
|
|
Capitalized internal-use software and website development costs
|
(2,956
|
)
|
|
(3,052
|
)
|
Purchases of property and equipment
|
(509
|
)
|
|
(61
|
)
|
Net cash used in investing activities
|
(3,465
|
)
|
|
(3,113
|
)
|
Financing activities:
|
|
|
|
|
|
Proceeds from borrowings under revolving line of credit
|
—
|
|
|
7,500
|
|
Payments on borrowings under revolving line of credit
|
—
|
|
|
(15,000
|
)
|
Payments for contingent acquisition consideration
|
—
|
|
|
(547
|
)
|
Payments for noncompete obligation
|
(96
|
)
|
|
(192
|
)
|
Class A common stock withheld in treasury from restricted share vesting
|
(842
|
)
|
|
(160
|
)
|
Issuances of Class A common stock under equity compensation plans
|
33
|
|
|
19
|
|
Issuances of Class A common stock from treasury
|
—
|
|
|
21
|
|
Purchases of Cass A common stock pursuant to share repurchase plan
|
(4,923
|
)
|
|
—
|
|
Distributions to member
|
(5,477
|
)
|
|
(1,996
|
)
|
Net cash used in financing activities
|
(11,305
|
)
|
|
(10,355
|
)
|
Net increase in cash and cash equivalents
|
27,131
|
|
|
4,519
|
|
Cash and cash equivalents at beginning of period
|
12,214
|
|
|
7,695
|
|
Cash and cash equivalents at end of period
|
$
|
39,345
|
|
|
$
|
12,214
|
|
|
|
|
|
|
|
Supplemental disclosure of non-cash financing activities:
|
|
|
|
|
|
Change in due to member related to Exchange Agreement
|
$
|
18,618
|
|
|
$
|
—
|
|
Change in deferred tax asset related to Exchange Agreement
|
(20,732
|
)
|
|
—
|
|
Issuance of Class A common stock in a private offering related to Exchange Agreement
|
16,487
|
|
|
—
|
|
Exchange of Class B membership interests related to Exchange Agreement
|
(14,374
|
)
|
|
—
|
|
Declared but unpaid distribution to member of Health Plan Intermediaries Holdings, LLC
|
638
|
|
|
2,761
|
|
The accompanying notes are an integral part of the consolidated financial statements
53
HEALTH INSURANCE INNOVATIONS, INC.
Notes to Consolidated Financial Statements
December 31, 2017
|
|
1.
|
Organization, Basis of Presentation, and Summary of Significant Accounting Policies
|
Health Insurance Innovations, Inc. is a Delaware corporation incorporated on October 26, 2012. In this annual report, unless the context suggests otherwise, references to the “Company,” “we,” “us” and “our” refer (1) prior to the February 13, 2013 closing of an initial public offering (“IPO”) of the Class A common stock of Health Insurance Innovations, Inc., to Health Plan Intermediaries, LLC (“HPI”) and Health Plan Intermediaries Sub, LLC (“HPIS”), its consolidated subsidiary, and (2) after the IPO, to Health Insurance Innovations, Inc. and its consolidated subsidiaries. The terms “HIIQ” and “HPIH” refer to the stand-alone entities Health Insurance Innovations, Inc., and Health Plan Intermediaries Holdings, LLC, respectively. The terms “HealthPocket” or “HP” refer to HealthPocket, Inc., our wholly owned subsidiary which was acquired by HPIH on July 14, 2014. The term “ASIA” refers to American Service Insurance Agency LLC, a wholly owned subsidiary which was acquired by HPIH on August 8, 2014. HPIH, HP and ASIA are consolidated subsidiaries of HIIQ.
Business Description and Organizational Structure of the Company
Our Business
We are a cloud-based technology platform and distributor of affordable individual and family health insurance plans (“IFP”) which include short-term medical (“STM”) insurance plans, and guaranteed-issue and underwritten health benefit insurance plans ("HBIP"), previously referred to as hospital indemnity plans. Through our technology platform, we also offer supplemental products which include a variety of additional insurance and non-insurance products that are frequently purchased as supplements to IFPs. We work in concert with carriers to help them develop products for our target markets. We are not an insurer and do not process or pay claims. The health insurance products we help develop are underwritten by third-party insurance carriers with whom we have no affiliation apart from our contractual relationships. We assume no underwriting, insurance or reimbursement risk.
We help design and structure IFPs and supplemental products in concert with insurance carriers and discount benefit providers. We market products to individuals through our internal distribution network, and we also use an external distribution network consisting of independently owned and operated licensed-agent call centers to market to individuals. For both our internal distribution network and our external distribution network, we collect money and manage the member's non-claims related experience for the IFPs and supplemental products.
STM plans feature a streamlined underwriting process offering immediate coverage options. STM plans generally offer qualifying individuals insurance benefits for fixed short-term durations. STM plans provide up to three months of health insurance coverage with a wide range of deductible and copay levels. In 2016, the Internal Revenue Service, the Employee Benefits Security Administration, and the U.S Department of Health and Human Services, collectively “HHS,” published Internal Revenue Bulletin 2016-47, which provided that, effective January 1, 2017, all STM plans submitted before April 1, 2017 must terminate no later than December 31, 2017, and effective April 1, 2017, new limits were set on STM duration to periods of less than three months but allowing for re-applications with the same or different health insurance carrier.
On February 20, 2018, the Departments of Health and Human Services, Labor, and Treasury, proposed a new rule that would change the way that short-term, limited duration insurance coverage (or short-term plans) is regulated. The proposed rule was developed in response to President Trump's executive order from October 2017 that directed the federal government to expand access to short-term plans, association health plans, and health reimbursement arrangements.
The new rule would extend the maximum duration of these plans from three months to "less than 12 months" (which could be as long as 364 days). The new rule also includes updated notice requirements. The proposed rule specifies that these new requirements would go into effect 60 days after publication of the final rule in the Federal Register. Comments from stakeholders regarding the proposed rule will be accepted until late April 2018. The Departments of Health and Human Services, Labor, and Treasury, will then need to consider these comments, draft a final rule, undergo inter-agency review, and then obtain approval by the Office for Management and Budget before releasing the final rule.
HBIPs are insurance products which include both guaranteed-issue and underwritten plans that pay fixed cash benefits, and additional benefits for certain plans, for covered procedures and services for individuals under the age of 65. These highly customizable products are generally on an open-provider network without copayments or deductibles and do not have defined policy term lengths.
We provide numerous low-cost supplemental insurance and discount benefit products, including pharmacy benefit cards, dental plans, vision plans, cancer/critical illness plans, deductible and gap protection plans, and life insurance policies that are frequently purchased as supplements to IFPs. These are typically monthly programs with automatic renewal that are not affected by the changes to rules relating to the maximum duration or renewal of STM products.
We manage member relations via email, through our online member portal, which is available 24 hours a day, seven days a week, and via telephone. Our online enrollment process allows us to aggregate and analyze consumer data and purchasing habits to track market trends and drive product innovation.
Our scalable, proprietary, and web-based technology platform provides members immediate access to the products we sell through our internal and third-party distribution channels. Members can tailor product selections to meet their personal insurance and budget needs, buy policies and print policy documents and identification cards in real-time. Our technology platform uses abbreviated online applications, some with health questionnaires, to provide an immediate "accept or reject" decision using rules and criteria determined by the carriers for the products we offer. Once an application is accepted, individuals can use our automated payment system to complete the enrollment process and obtain instant electronic access to their policy fulfillment documents, including the insurance policy, benefits schedule and identification cards. We receive credit card and Automated Clearing House (“ACH”) payments directly from members at the time of sale. Our technology platform provides scalability and, on a per-policy-basis, reduces the costs associated with marketing, selling, and administering policies.
Our sales of IFP and supplemental products focus on the under-penetrated segment of the U.S. population who are uninsured or underinsured. These respective classes include individuals not covered by employer-sponsored insurance plans, such as the self-employed, small business owners and their employees, individuals who are unable to afford the rising cost of IMM premiums, underserved “gap populations” that require insurance due to changes caused by life events, such as new graduates, divorcees, early retirees, military discharges, the unemployed, part-time and seasonal employees and potential members seeking health insurance between the open enrollment periods created under the Patient Protection and Affordable Care Act (“PPACA”).
As the managing general underwriter and/or broker of IFP and supplemental products, we receive all amounts due in connection with the plans we sell and administer on behalf of the service providers. We refer to these total collections as "premium equivalents," which typically represent a combination of premiums, fees for discount benefit plans, enrollment fees, and direct commission payments. From premium equivalents, we remit risk premiums to carriers and amounts earned by discount benefit plan providers, who we refer to as third-party obligors, as such carriers and third-party obligors are the ultimate parties responsible for providing the insurance coverage or discount benefits to the member. Our revenues consist of the net balance of the premium equivalents.
We collect premium equivalents upon the initial sale of the plan and then monthly upon each subsequent periodic payment under such plan. We receive most premium equivalents through online credit card or ACH processing. As a result, we have limited accounts receivable. We generally remit the risk premium to the applicable carriers and the amounts earned by third-party obligors on a monthly basis based on their respective compensation arrangements.
We also provide consumers with access to health insurance information search and comparison technology through our website, HealthPocket.com. This website allows consumers to easily and clearly compare and rank health insurance plans available for an individual, family or small business, empowering consumers to make health plan decisions and reduce their out-of-pocket costs.
In 2015, we launched a direct-to-consumer insurance website that allows consumers to research health insurance trends, comparison shop, and purchase IFP under the AgileHealthInsurance® brand. AgileHealthInsurance.com (“Agile”) is one of the few internet sites dedicated to helping consumers understand the benefits of Term Health Insurance and HBIP. We use the term “Term Health Insurance” to refer to fixed-term health insurance products of less than one year in duration, such as STM plans. These IFP plans are the culmination of extensive research on health insurance needs in the PPACA era, and we believe consumers will be able to find affordable prices for these plans on Agile. Agile utilizes what we believe is a best-in-class plan comparison and online enrollment tool for STM and HBIP.
Our History
Our business began operations as HPI in 2008. To facilitate the IPO, HIIQ was incorporated in the State of Delaware in October 2012. In November 2012, through a series of transactions, HPI assigned the operating assets of our business to HPIH, and HPIH assumed the operating liabilities of HPI. Since November 2012, we have operated our business through HPIH and its subsidiaries.
Our Reorganization and IPO
HIIQ sold
4,666,667
shares of common stock for
$14.00
per share in the IPO on February 13, 2013. Simultaneous with the offering, HIIQ obtained a
35%
membership interest,
35%
economic interest and
100%
of the voting interest in HPIH.
Upon completion of the offering, HIIQ became a holding company the principal asset of which is its interest in HPIH. All of HIIQ’s business is conducted through HPIH and its subsidiaries. HIIQ is the sole managing member of HPIH and has
100%
of the voting rights and control.
HIIQ has two classes of outstanding capital stock: Class A common stock and Class B common stock. Class A shares represent
100%
of the economic rights of the holders of all classes of our common stock to share in our distributions. Class B shares do not entitle their holders to any dividends paid by, or rights upon liquidation of, HIIQ. Shares of our Class A common stock vote together with shares of our Class B common stock as a single class, except as otherwise required by law. Each share of our Class A common stock and our Class B common stock entitles its holder to one vote. As of
December 31, 2017
, Mr. Kosloske, our Chief of Product Innovation, beneficially owns
23.7%
of our outstanding Class A common stock and Class B common stock on a combined basis, which equals his combined economic interest in the Company.
HPIH has two series of outstanding equity: Series A Membership Interests, which may only be issued to HIIQ, as sole managing member, and Series B Membership Interests. The Series B Membership Interests are held by HPI and HPIS, entities beneficially owned by Mr. Kosloske. As of
December 31, 2017
, and
2016
, (i) the Series A Membership Interests held by HIIQ represent
76.3%
and
54.0%
, respectively, of the outstanding membership interests,
76.3%
and
54.0%
, respectively, of the economic interests and
100%
of the voting interests in HPIH and (ii) the Series B Membership Interests held by the entities beneficially owned by Mr. Kosloske represent
23.7%
and
46.0%
, respectively, of the outstanding membership interests, as well as
23.7%
and
46.0%
, respectively, of the economic interests and no voting interest in HPIH.
Business Acquisitions
Acquisition of HP
On July 14, 2014, we entered into an agreement to acquire HP from Mr. Bruce Telkamp (“Telkamp”), Dr. Sheldon Wang (“Wang”) and minority equity holders of HP. The closing of the acquisition occurred on July 14, 2014 simultaneous with the signing of the agreement.
Acquisition of ASIA
On August 8, 2014, we entered into an agreement to acquire all of the issued and outstanding membership interests of ASIA, a Texas insurance brokerage. The closing of the acquisition occurred on August 8, 2014 simultaneous with the signing of the agreement.
Principles of Consolidation and Basis of Presentation
The accompanying consolidated financial statements have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”). The consolidated financial statements include the accounts of Health Insurance Innovations, Inc., its wholly owned subsidiaries, one of which is a Variable Interest Entity (“VIE”), of which the Company is the primary beneficiary. See Note 2 for further information on the VIE. All significant intercompany balances and transactions have been eliminated in preparing the consolidated financial statements. The results of operations for business combinations are included from their respective dates of acquisition.
Noncontrolling interests are included in the consolidated balance sheets as a component of stockholders’ equity that is not attributable to the equity of the Company. We report separately the amounts of consolidated net loss or income attributable to us and noncontrolling interests.
As an “emerging growth company” as defined in the Jumpstart Our Business Startups Act of 2012 (the “JOBS Act”), we benefit from certain temporary exemptions from various reporting requirements, including, but not limited to, not being required to comply with the auditor attestation requirements of Section 404 of the Sarbanes-Oxley Act and reduced disclosure obligations regarding executive compensation in our periodic reports and proxy statements. We have also elected under the JOBS Act to delay the adoption of new and revised accounting pronouncements applicable to public companies until such pronouncements are made applicable to private companies. As a result of this election, our financial statements may not be comparable to companies that comply with public company effective dates. These exemptions will apply for a period of
five years
following the completion of
our IPO which closed on February 13, 2013. The Company will cease to be an emerging growth company as of December 31, 2018.
Use of Estimates
The preparation of the consolidated financial statements in conformity with accounting principles generally accepted in the United States of America (“GAAP”) requires management to make estimates, judgments, and assumptions that affect the reported amounts of assets and liabilities at the date of the consolidated financial statements. These estimates also affect the reported amounts of revenue and expenses during the reporting periods. Actual results could differ materially from those estimates.
Summary of Significant Accounting Policies
Revenue
Recognition
Our revenues primarily consist of commissions and fees earned for health insurance policies and supplemental products issued to members, referral fees, and fees for discount benefit plans paid by members as a direct result of our enrollment services, brokerage services or referral sales. Revenues reported by the Company are net of risk premiums remitted to insurance carriers and fees paid for discount benefit plans. Revenues are net of an allowance for policies expected to be canceled by members during a limited cancellation period. We establish an allowance for estimated policy cancellations through a charge to revenues. The allowance is estimated using historical data to project future experience. Such estimates and assumptions could change in the future as more information becomes known, which could impact the amounts reported. We periodically review the adequacy of the allowance and record adjustments as necessary. The net allowance for estimated policy cancellations as of
December 31, 2017
and
2016
was
$471,000
and
$641,000
, respectively.
Commission rates for our products are agreed to in advance with the relevant insurance carrier and vary by carrier and policy type. Under our carrier compensation arrangements, the commission rate schedule that is in effect on the policy effective date governs the commissions over the life of the policy. All amounts due to insurance carriers and discount benefit vendors are reported and paid to them in accordance with contractual agreements.
In addition, we earn enrollment and administration fees on policies issued. All amounts due to insurance carriers and discount benefit vendors are reported and paid to them according to the procedures provided for in the contractual agreements between the individual carrier or vendor and us. Risk premiums are typically reported and remitted to insurance carriers on the 15th of the month following the end of the month in which they are collected. Revenue related to enrollment and administration fees are recognized upon collection from the member.
In concluding that revenues should be reported on a net basis, we considered Financial Accounting Standards Board (“FASB”) requirements and whether we have the responsibility to provide the goods or services to the customer or if we rely on a supplier to provide the goods or services to the customer. We are not the ultimate party responsible for providing the insurance coverage or discount benefits to the member and, therefore, we are not the primary obligor in the arrangement. The supplier, or insurance carrier, bears the risk for that insurance coverage. We therefore report our revenues net of amounts paid to the contracted insurance carrier companies and discount benefit vendors.
Third-Party Commissions and Advanced Commissions
We utilize a broad network of licensed third-party distributors, in addition to our internal distributors to sell the plans that we help develop. We pay commissions to these distributors based on a percentage of the policy premium that varies by type of policy. We also pay fees to some distributors for discount benefit plans issued.
Advanced commissions outstanding as of
December 31, 2017
and
2016
totaled
$39.5 million
and
$37.0 million
, respectively. Advanced commissions consist of amounts advanced to certain third-party distributors. We perform ongoing credit evaluations of our distributors, all of which are located in the United States. We recover the advanced commissions by withholding future commissions earned on premiums collected over the period in which policies renew. While we have not experienced any significant write-offs from commission advances, we have recognized an allowance for bad debt expense of
$180,000
and
$454,000
as of
December 31, 2017
and
2016
, respectively. In addition, from time to time, certain of these advanced commissions arrangements include a loan agreement for the purposes of securing the advanced payments we make. Generally, these advances will be repaid by withholding payments on future commissions earned by the distributor, as described in the respective agreements. A fee for the advance commission of up to
2%
of the insurance premium sold is charged to the distributors and recognized as a reduction of the related commissions expense over the period of advance. The reductions of commission expense related to this practice for the years ended
December 31, 2017
and
2016
were
$2.3 million
and
$2.6 million
, respectively.
Cash and Cash Equivalents
We account for cash on hand and demand deposits with banks and other financial institutions as cash. Short-term, highly liquid investments with original maturities of three months or less, when purchased, are considered cash equivalents. Investments in cash equivalents include, but are not limited to, demand deposit accounts, money market accounts and certificates of deposit with original maturities of three months or less.
Restricted Cash
In our capacity as the managing general underwriter, we collect premiums from members and distributors and, after deducting our earned commission and fees, remit these risk premiums to our contracted insurance carriers, discount benefit vendors and distributors. Where contractually obligated, we hold the unremitted funds in a fiduciary capacity until they are disbursed, and the use of such funds is restricted. We hold these funds in bank accounts. These unremitted amounts are reported as restricted cash in the accompanying consolidated balance sheets with the related liabilities reported in accounts payable and accrued expenses. The Company previously referred to such restricted cash as cash held on behalf of others at
December 31, 2016
. Restricted cash at
December 31, 2017
and
2016
was
$14.9 million
and
$11.9 million
, respectively.
Accounts Receivable
Accounts receivable represent amounts due to us for premiums collected by a third-party and are generally considered delinquent 15 days after the due date. The underlying insurance contracts are canceled retroactively if the payment remains delinquent. We have not experienced any material credit losses from accounts receivable and have not recognized a significant provision for uncollectible accounts receivable.
Property and Equipment
Property and equipment is recorded at cost, less accumulated depreciation, in the accompanying consolidated balance sheets. Depreciation expense for property and equipment is computed using the straight-line method over the following estimated useful lives:
|
|
|
Website development and internal-use software (1)
|
3 – 5 years
|
Computer equipment
|
5 years
|
Furniture and fixtures
|
7 years
|
Leasehold improvements
|
Shorter of the lease term or estimated useful life
|
(1) Included in property and equipment, net are certain website development and internally developed software costs. These costs incurred in the development of websites and internal-use software are either expensed as incurred or capitalized depending on the nature of the cost and the stage of development of the project under which a website or internal-use software are developed. The capitalization policies for website development and internal-use software vary as described below.
Website development
Generally, the costs incurred during the planning stage are expensed as incurred; costs incurred for activities during the website application and infrastructure development stage are capitalized; costs incurred during the graphics development stage are capitalized if such costs are for the creation of initial graphics for the website; subsequent updates to the initial graphics are expensed as incurred, unless they provide additional functionality; costs incurred during the content development stage are expensed as incurred unless they are for the integration of a database with the website, which are capitalized; and the costs incurred during the operating stage are expensed as incurred.
Upon reaching the operating phase of the website application and infrastructure phase, the capitalized costs are amortized over the estimated useful life of the asset, which we generally expect to be five years.
During the year ended December 31, 2015, we capitalized
$895,000
of costs incurred, consisting primarily of direct labor, in the development of a website for which the software underlying the website will not be marketed externally. The operating phase of the development of this website commenced on July 1, 2015.
No
additional costs have since been capitalized. During
each of the years ended
December 31, 2017
and
2016
, approximately
$179,000
of amortization has been recorded related to the capitalized website development costs.
Internal-use software
Generally, the costs incurred during the preliminary project stage are expensed as incurred; costs incurred for activities during the application development stage are capitalized; and costs incurred during the post-implementation/operation stage are expensed as incurred.
Upon reaching the post-implementation/operation stage of the development of internal-use software, the capitalized costs are amortized over the estimated useful life of the asset, which we generally expect to be
3 years
.
For the year ended
December 31, 2017
and
2016
, we capitalized
$3.0 million
and
$3.1 million
, respectively, of costs incurred, consisting primarily of direct labor, in the application development stage of the internal-use software. Substantially all of the costs incurred during the period were part of the application development phase. For the year ended
December 31, 2017
and
2016
, there was
$1.7 million
and
$774,000
, respectively, of amortization expense recorded for projects in the post-implementation/operation phase of development.
The Company’s management periodically reviews long-lived assets for impairment whenever events or changes in business circumstances indicate that the carrying value of the assets may not be recoverable.
No
impairment losses were recognized for the periods presented.
Goodwill and Other Intangible Assets
Goodwill
As a result of our various acquisitions, we have recorded goodwill which represents the excess of the consideration paid over the fair value of the identifiable net assets acquired in a transaction accounted for as a business combination. An impairment test is performed by us at least annually as of October 1st of each year, or whenever events or circumstances indicate a potential for impairment.
Under FASB guidance, we have the option of performing a qualitative assessment to determine whether based on the facts and circumstances it is more likely than not that the fair value of the reporting unit exceeds the carrying value of its net assets. A qualitative assessment requires judgments involving relevant factors, including but not limited to, changes in the general economic environment, industry and regulatory considerations, current economic performance compared to historical economic performance and other relevant company-specific events such as changes in management, key personnel or business strategy, where applicable. If we elect to bypass the qualitative assessment, or if we determine, based upon our assessment of those qualitative factors that it is more likely than not that the fair value of the unit is less than its carrying value, a quantitative assessment for impairment is required. The quantitative assessment for evaluating the potential impairment of goodwill involves a two-step assessment process which requires significant estimates and judgments by us to be used during the analysis. In step one we determine if there is an indication of goodwill impairment by determining the fair value of the reporting unit’s net assets and comparing that value to the reporting unit’s carrying value including the goodwill. If the carrying value of the net assets exceed the fair value, then the second step of the impairment assessment is required. The step two assessment determines if an impairment exists, and if so, the magnitude of the impairment by comparing the estimated fair value of the reporting unit’s goodwill with the carrying amount of that goodwill. The excess of the carrying value over the estimated fair value of the goodwill determines the amount of impairment which would then be recorded as a loss on our statement of income in the year the impairment occurred. See Note 11 for further information on our reporting unit.
While performing an impairment assessment we use a combination of valuation approaches including the market approach and the income approach.
The market approach uses a guideline company methodology, which is based upon a comparison of the reporting unit to similar publicly-traded companies within our industry. We derive a market value of invested capital or business enterprise value for each comparable company by multiplying the price per share of common stock of the publicly traded companies by their total common shares outstanding and adding each company’s current level of debt. We calculate a business enterprise multiple based on revenue and earnings from each company, then apply those multiples to our revenue and earnings to calculate a business enterprise value. Assumptions regarding the selection of comparable companies are made based on, among other factors, capital structure, operating environment and industry. As the comparable companies were typically larger and more diversified than our
business, multiples were adjusted prior to application to our revenues and earnings to reflect differences in margins, long-term growth prospects and market capitalization.
The income approach uses a discounted debt-free cash flow analysis to measure fair value by estimating the present value of future economic benefits. To perform the discounted debt-free cash flow analysis, we develop a pro forma analysis of the reporting unit to estimate future available debt-free cash flow and discounting estimated debt-free cash flow by an estimated industry weighted average cost of capital based on the same comparable companies used in the market approach. Per FASB guidance, the weighted average cost of capital is based on inputs (e.g., capital structure, risk, etc.) from a market participant’s perspective and not necessarily from the reporting unit’s perspective. Future cash flow is projected based on assumptions for our economic growth, industry expansion, future operations and the discount rate, all of which require significant judgments by management.
We establish our assumptions and arrive at the estimates used in these calculations based upon our historical experience, knowledge of our industry and by incorporating third-party data, which we believe results in a reasonably accurate approximation of fair value. Nevertheless, changes in the assumptions used could have an impact on our assessment of recoverability. We believe our projected sales are reasonable based on, among other things, available information regarding our industry. We also believe the discount rate is appropriate. The weighted average discount rate is impacted by current financial market trends and will remain dependent on such trends in the future.
After computing a separate business enterprise value under the above approaches, we apply a weighting to them to derive the business enterprise value of the reporting unit. The weightings are evaluated each time a goodwill impairment assessment is performed and give consideration to the relative reliability of each approach at that time. The estimated fair value is then compared to the reporting unit’s carrying value.
The Company performed its annual impairment analysis as of October 1, 2017 and 2016, respectively, and upon completion of the analysis in step one we determined that the fair value of the reporting unit exceeded its carrying value, each year. As such, a step two analysis was not required. Our goodwill balance arose from our previous acquisitions. See above for details on historic acquisitions and Note 4 for further discussion of our goodwill.
Other Intangible Assets
Our other intangible assets arose primarily from acquisitions. Finite-lived intangible assets are amortized over their useful lives from
two
to
fifteen
years. See Note 4 for further discussion of our intangible assets.
Definite-lived intangible assets are reviewed for impairment whenever events or changes in circumstances indicate that the carrying amount of an asset or asset group may not be recoverable. Recoverability of the asset or asset group is measured by comparison of its carrying amount to undiscounted future net cash flows the asset is expected to generate. If the carrying amount of an asset or asset group is not recoverable, we recognize an impairment loss based on the excess of the carrying amount of the long-lived asset or asset group over its respective fair value which is generally determined as the present value of estimated future cash flows or as the appraised value.
No
impairments on intangible assets were recorded during the year ended
December 31, 2017
and
2016
.
Advertising and Marketing Costs
Advertising and marketing costs are expensed as incurred. Advertising and marketing expenses for the years ended
December 31, 2017
and
2016
were
$11.5 million
and
$11.1 million
respectively and are classified as selling, general and administrative expense (“SG&A”).
Accounting for Stock-based Compensation
Expense for stock-based compensation is recognized based upon estimated grant date fair value and is amortized over the requisite service period of the awards using the accelerated method. We offer awards which vest based on service conditions, performance conditions, or market conditions. For grants of stock appreciation rights ("SARs") and stock options, we apply the Black-Scholes option-pricing model, a Monte Carlo Simulation, or a lattice model, depending on the vesting conditions, in determining the fair value of share-based payments to employees. These models incorporate various assumptions, including expected volatility and expected term. Volatility is calculated using the Company’s trading history. The expected term of awards granted is based on the Company’s best estimate and the use of the simplified method for “plain vanilla” awards under GAAP, where applicable.
The resulting compensation expense is recognized over the requisite service period. The requisite service period is the period during which an employee is required to provide service in exchange for an award, which often is the vesting period. Compensation expense is recognized only for those awards expected to vest. In accordance with GAAP, compensation expense is not recognized for awards with performance vesting conditions until it is deemed probable that the underlying performance events will occur. All stock-based compensation expense is classified within SG&A expense in the consolidated statements of income.
We do not believe there is a reasonable likelihood there will be a material change in the future estimates or assumptions we use to determine stock-based compensation expense. See Note 8 for further discussion of stock-based compensation.
Accounting for Income Taxes
HPIH is taxed as a partnership for federal income tax purposes; as a result, it is not subject to entity-level federal or state income taxation but its members are liable for taxes with respect to their allocable shares of each company’s respective net taxable income.
We are subject to U.S. corporate federal, state and local income taxes that are attributable to HIIQ as reflected in our consolidated financial statements. We use the liability method of accounting for income taxes. Significant management judgment is required in determining the provision for income taxes and, in particular, any valuation allowance that is recorded or released against our deferred tax assets.
We evaluate quarterly the positive and negative evidence regarding the realization of net deferred tax assets. The carrying value of our net deferred tax assets is based on our belief that it is more likely than not that we will generate sufficient future taxable income to realize these deferred tax assets.
We account for uncertainty in income taxes using a two-step process. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence indicates that it is more likely than not that the position will be sustained upon audit, including resolution of related appeals or litigation processes, if any. The second step requires us to estimate and measure the tax benefit as the largest amount that is more than 50% likely to be realized upon ultimate settlement. Such amounts are subjective, as a determination must be made on the probability of various possible outcomes. We reevaluate uncertain tax positions on a quarterly basis. This evaluation is based on factors including, but not limited to, changes in facts or circumstances, changes in tax law, effectively settled issues under audit, and new audit activity. Such a change in recognition and measurement could result in recognition of a tax benefit or an additional tax provision. The Company accounts for interest and penalties associated with uncertain tax positions as a component of tax expense, and none were included in the Company’s financial statements as there are not uncertain tax positions outstanding as of
December 31, 2017
and
2016
, respectively. See Note 9 for further discussion of income taxes.
Basic and Diluted Earnings per Share
Basic earnings per share is determined by dividing the net earnings attributable to Class A common stockholders by the weighted average number of Class A common shares and participating securities outstanding during the period. Participating securities are included in the basic earnings per share calculation when dilutive. Diluted earnings per share is determined by dividing the net income attributable to common stockholders by the weighted average number of common shares and potential common shares outstanding during the period. Potential common shares are included in the diluted earnings per share calculation when dilutive. Potential common shares consisting of common stock issuable upon exercise of outstanding SARs and options are computed using the treasury stock method. See Note 10 for further discussion of earnings per share.
The Company has two classes of common stock: Class A common stock and Class B common stock. Holders of each of Class A common stock and Class B common stock are entitled to one vote per share on all matters to be voted upon by the shareholders, and holders of each class will vote together as a single class on matters presented to our stockholders for their vote or approval, except as otherwise required by applicable law. For more information on our classes of stock, see Note 7.
Recent Accounting Pronouncements
In the following summary of recent accounting pronouncements, all references to effective dates of Financial Accounting Standards Board (“FASB”) guidance relate to nonpublic entities. As noted above, we have elected to delay the adoption of new and revised accounting pronouncements applicable to public companies until such pronouncements are made applicable to private companies under the provisions of the JOBS Act.
Recently adopted accounting pronouncements
In March 2016, the FASB issued ASU 2016-09, Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting, as part of the FASB’s simplification initiative. The amendment affects all entities that issue share-based payment awards to their employees. The areas for simplification involve several aspects of the accounting for share-based payment transactions, including the income tax consequences, classification of awards as either equity or liabilities, and classification on the statement of cash flows. Some of the areas for simplification apply only to nonpublic entities. For public business entities, the amendments in this update are effective for annual periods beginning after December 15, 2016, and interim periods within those annual periods. For all other entities, the amendments are effective for annual periods beginning after December 15, 2017, and interim periods within annual periods beginning after December 15, 2018. Early adoption is permitted for any entity in any interim or annual period.
The Company elected to early adopt this update during the quarter ended March 31, 2017. The Company’s former Chief Executive Officer exercised
1.0 million
Stock Appreciation Rights in February 2017. Early adoption of this update was favorable in light of the material exercise and as a result of this adoption, during the three months ended March 31, 2017, excess tax benefits of
$3.3 million
related to vested and exercised share-based compensation awards were recorded as a decrease in income tax expense and resulted in a
$0.38
increase in our first-quarter basic earnings per share. For the year ended December 31, 2017, total excess tax benefits realized was
$4.2 million
.
Recently issued accounting pronouncements
In May 2017, the FASB issued Accounting Standards Update (“ASU”) No. 2017-09, Compensation-Stock Compensation (Topic 718): Scope of Modification Accounting, which clarifies when to account for a change to the terms or conditions of a share-based payment award as a modification. Under the new guidance, modification accounting is required only if the fair value, the vesting conditions, or the classification of the award (as equity or liability) changes as a result of the change in terms or conditions. The amendments are effective for all entities for annual periods, and interim periods within those annual periods, beginning after December 15, 2017. Early adoption is permitted. We are currently evaluating the impact of adopting this standard, and will adopt this guidance on December 31, 2018, the date our emerging growth company status expires. We do not expect it to have a significant impact on our consolidated financial statements and disclosures. We will adopt this standard prospectively as required by the standard.
In January 2017, the FASB issued ASU No. 2017-04, Intangibles-Goodwill and Other (Topic 350): Simplifying the Test for Goodwill Impairment, which eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value. This guidance will be effective for interim or annual goodwill impairment tests in fiscal years beginning after December 15, 2019 and will be applied prospectively. Early adoption is permitted for any impairment tests performed after January 1, 2017. The Company does not believe that this guidance will have a material impact on our consolidated financial statements.
In November 2016, the FASB issued ASU No. 2016-18, Statement of Cash Flows (Topic 230): Restricted Cash, which requires companies to include amounts generally described as restricted cash and restricted cash equivalents in cash and cash equivalents when reconciling beginning-of-period and end-of-period total amounts shown on the statement of cash flows. We are required to adopt this guidance on December 31, 2018, the date our emerging growth company status expires however early adoption is permitted, including adoption in an interim period. The Company will adopt this standard in its first quarter of 2018 utilizing the retrospective adoption method. This update will change the presentation of the cash flow statement since the Company has a material amount of restricted cash.
In August 2016, the FASB issued ASU No. 2016-15, Statement of Cash Flows (Topic 230): Classification of Certain Cash Receipts and Cash Payments, which provides amendments to the codification for eight specific cash flow issues such as the classification of debt prepayment or debt extinguishment costs to the classification of the proceeds from the settlement of insurance claims. The amendments in this update are effective for public business entities for fiscal years beginning after December 15, 2017, and interim periods within those fiscal years. For all other entities, the amendments are effective for fiscal years beginning after December 15, 2018, and interim periods within fiscal years beginning after December 15, 2019. Early adoption is permitted, including adoption in an interim period. The Company will adopt this guidance on December 31, 2018, the date our emerging growth company status expires. The standard will be implemented using a retrospective transition method to each period presented, except where it is impracticable, and the amendments for those issues will be applied prospectively. We are currently evaluating the impact of this guidance on our consolidated financial statements.
In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842), which modifies lease accounting for lessees to increase transparency and comparability by requiring organizations to recognize lease assets and lease liabilities on the balance sheet and increasing disclosures about key leasing arrangements. The amendment updates the critical determinant from capital versus operating to whether a contract is or contains a lease because lessees are required to recognize lease assets and lease liabilities for all leases - financing and operating - other than short term. The amendments in this update are effective for public business entities for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years. Early adoption is permitted. We will adopt this guidance in reporting periods beginning after December 15, 2018. The adoption of this standard will impact the Company’s consolidated balance sheet, but the Company is still assessing any other impacts this standard will have on its consolidated financial statements. The Company does not believe that the impact of adopting this standard will be material to the consolidated financial statements.
In May 2014, the FASB issued ASU No. 2014-09, Revenue from Contracts with Customers (Topic 606) which amends the existing revenue recognition standards. The standard is based on the principle that an entity should recognize revenue to depict the transfer of goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. In addition, new and enhanced disclosures will be required. For a public entity, the standard becomes effective for annual and interim reporting periods beginning after December 15, 2017. For all other entities, the amendments in this update are effective for reporting periods beginning after December 15, 2018. The new standard is required to be applied retrospectively to each prior reporting period presented or retrospectively with the cumulative effect of its application recognized at the date of initial application. We have not yet selected a transition method. We are managing the implementation of this new standard in close consultation with our Audit Committee. We have established a cross functional project steering committee and implementation team to identify potential differences that would result from applying the requirements of the new standard to our revenue contracts and related expense line items. We have identified the various revenue streams, including product revenues and service revenues that could be impacted by the new standard and have reviewed individual customer contracts related to these revenue streams to determine if any material differences exist between the current and new revenue standards. We have not completed our assessment of the new revenue recognition standard and have not yet determined the impact of adoption on our consolidated financial statements. We anticipate that we will complete our assessment of the new standard and the potential financial impact by the end of the second quarter of fiscal year 2018. We will adopt this guidance on December 31, 2018, the date our emerging growth company status expires.
The Company has reviewed all other recently issued, but not yet effective, accounting pronouncements and does not believe the future adoption of any such pronouncements may be expected to cause a material impact on our financial statements.
|
|
2.
|
Variable Interest Entities
|
As of
December 31, 2017
, we are the primary beneficiary of one entity, HPIH, that constitutes a VIE pursuant to FASB guidance. HPIH is a VIE as the voting rights of the investors are not proportional to their obligations to absorb the expected losses of HPIH. We hold
100%
of the voting power in HPIH, but
76.3%
of the total membership and economic interest, and the other members of HPIH hold no voting rights in HPIH. Further, substantially all of the activities of HPIH are conducted on behalf of a membership with disproportionately few voting rights. We have concluded that we are the primary beneficiary of HPIH, and, therefore, should consolidate HPIH since we have power over and receive the benefits of HPIH. We have the power to direct the activities of HPIH that most significantly impact its economic performance. Our equity interest in HPIH obligates us to absorb losses of HPIH and gives us the right to receive benefits from HPIH related to the day-to-day operations of the entity, both of which could potentially be significant to HPIH. As such, our maximum exposure to loss as a result of our involvement in this VIE is the net income or loss allocated to us based on our interest. As of
December 31, 2017
and
2016
, HIIQ holds
100%
of the voting power, respectively, and
76.3%
and
54.0%
of the membership and economic interest in HPIH, respectively. See Note 7 for further information on our ownership structure.
|
|
3.
|
Property and Equipment
|
Property and equipment, net, are comprised of the following ($ in thousands):
|
|
|
|
|
|
|
|
|
|
December 31,
|
|
2017
|
|
2016
|
Computer equipment
|
$
|
686
|
|
|
$
|
373
|
|
Furniture and fixtures
|
211
|
|
|
192
|
|
Leasehold improvements
|
417
|
|
|
246
|
|
Website development and internal-use software
|
7,798
|
|
|
4,836
|
|
Total property and equipment
|
$
|
9,112
|
|
|
$
|
5,647
|
|
Less accumulated depreciation
|
3,704
|
|
|
1,625
|
|
Total property and equipment, net
|
$
|
5,408
|
|
|
$
|
4,022
|
|
Depreciation expense, including depreciation related to capitalized website development and internal-use software, was approximately
$2.1 million
and
$1.1 million
, respectively, for the years ended
December 31, 2017
and
2016
.
|
|
4.
|
Goodwill and Intangible Assets
|
Goodwill
Goodwill has been recorded as a result of previous acquisitions. There were no additions to goodwill during the year ended
December 31, 2017
. See Note 1 for further discussion of our history of acquisitions.
No
losses on impairment of goodwill were recorded during the years ended
December 31, 2017
, or
2016
. The carrying amounts as of
December 31, 2017
and
2016
were
$41.1 million
.
Other intangible assets
Our other intangible assets arose primarily from the acquisitions described above and consist of a brand, the carrier network, distributor relationships, customer relationships, noncompete agreements and capitalized software. Finite-lived intangible assets are amortized over their useful lives from
two
to
fifteen
years.
Major classes of intangible assets, net as of
December 31, 2017
consisted of the following ($ in thousands):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted-average Amortization (years)
|
|
Gross Carrying Amount
|
|
Accumulated Amortization
|
|
Intangible Assets, net
|
Brand
|
14.1
|
|
$
|
1,377
|
|
|
$
|
(396
|
)
|
|
$
|
981
|
|
Carrier network
|
5.0
|
|
40
|
|
|
(40
|
)
|
|
—
|
|
Distributor relationships
|
6.8
|
|
4,059
|
|
|
(3,428
|
)
|
|
631
|
|
Noncompete agreements
|
4.7
|
|
987
|
|
|
(987
|
)
|
|
—
|
|
Customer relationships
|
5.8
|
|
1,484
|
|
|
(1,154
|
)
|
|
330
|
|
Capitalized software
|
6.7
|
|
8,571
|
|
|
(4,571
|
)
|
|
4,000
|
|
Total intangible assets
|
|
|
$
|
16,518
|
|
|
$
|
(10,576
|
)
|
|
$
|
5,942
|
|
Major classes of intangible assets as of
December 31, 2016
consisted of the following ($ in thousands):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Weighted-average Amortization (years)
|
|
Gross Carrying Amount
|
|
Accumulated Amortization
|
|
Intangible Assets, net
|
Brand
|
14.1
|
|
$
|
1,377
|
|
|
$
|
(311
|
)
|
|
$
|
1,066
|
|
Carrier network
|
5.0
|
|
40
|
|
|
(40
|
)
|
|
—
|
|
Distributor relationships
|
6.8
|
|
4,059
|
|
|
(2,831
|
)
|
|
1,228
|
|
Noncompete agreements
|
4.7
|
|
987
|
|
|
(881
|
)
|
|
106
|
|
Customer relationships
|
5.8
|
|
1,484
|
|
|
(1,125
|
)
|
|
359
|
|
Capitalized software
|
6.7
|
|
8,571
|
|
|
(3,423
|
)
|
|
5,148
|
|
Total intangible assets
|
|
|
$
|
16,518
|
|
|
$
|
(8,611
|
)
|
|
$
|
7,907
|
|
Amortization expense for year ended
December 31, 2017
, and
2016
was
$2.0 million
and
$2.2 million
, respectively.
Estimated annual pretax amortization for intangibles assets in each of the next five years and thereafter are as follows ($ in thousands):
|
|
|
|
|
2018
|
$
|
1,725
|
|
2019
|
1,338
|
|
2020
|
1,338
|
|
2021
|
685
|
|
2022
|
114
|
|
Thereafter
|
742
|
|
Total
|
$
|
5,942
|
|
Reviews of other intangible assets are performed at each reporting period in accordance with GAAP.
No
impairments were noted during the years ended
December 31, 2017
or
2016
.
|
|
5.
|
Accounts Payable and Accrued Expenses
|
Accounts payable and accrued expenses as of
December 31, 2017
and
2016
consisted of the following ($ in thousands):
|
|
|
|
|
|
|
|
|
|
December 31,
|
|
2017
|
|
2016
|
Carriers and vendors payable
|
$
|
14,726
|
|
|
$
|
11,385
|
|
Commissions payable
|
8,811
|
|
|
5,710
|
|
Accrued wages
|
7,116
|
|
|
4,206
|
|
Accrued refunds
|
1,940
|
|
|
3,238
|
|
Accounts payable
|
3,725
|
|
|
928
|
|
Accrued professional fees
|
820
|
|
|
910
|
|
Accrued credit card/ACH fees
|
483
|
|
|
430
|
|
Accrued restructuring
|
—
|
|
|
3
|
|
Other accrued expenses
|
2,104
|
|
|
2,870
|
|
Total accounts payable and accrued expenses
|
$
|
39,725
|
|
|
$
|
29,680
|
|
On July 17, 2017, the Company, through HPIH, entered into a Credit Agreement (the “Credit Agreement”) among HPIH, and certain of its affiliates as guarantors, and SunTrust Bank, as lender (the “Lender”). The Credit Agreement provides for a
$30.0 million
revolving credit facility (the “Credit Facility”) pursuant to which the Lender has agreed to make revolving loans and issue letters of credit. The Credit Facility will be used for general corporate purposes, including funding of ongoing working capital needs, capital expenditures, and permitted acquisitions. The Credit Facility also provides HPIH with the right to request additional incremental term loans thereunder up to an aggregate additional amount of
$20.0 million
, subject to the satisfaction of certain additional conditions provided therein.
The Credit Facility matures on July 17, 2020 (the “Termination Date”) and borrowings under the Credit Agreement can either be, at HPIH’s election: (i) at the Base Rate (which is the highest of the prime rate, the federal funds rate plus
0.50%
, the one-month LIBOR index rate plus
1.00%
, and
zero
) plus a spread ranging from
0.75%
to
1.25%
or (ii) at Adjusted LIBOR (as defined in the Credit Agreement) plus a spread ranging from
1.75%
to
2.25%
. The applicable spread is dependent upon HPIH’s Consolidated Total Leverage Ratio (as defined in the Credit Agreement). Interest accrued on each Base Rate Loan (as defined in the Credit Agreement) is payable in arrears on the last day of each calendar quarter and on the Termination Date. Interest accrued on each Eurodollar Loan (as defined in the Credit Agreement) is payable on the last day of the applicable interest period, or every three months, whichever comes sooner, and on the Termination Date.
The Credit Facility is secured by: (i) a first priority lien on substantially all of the assets (subject to certain excluded assets) of HPIH and certain of its affiliates (including the Company) and (ii) pledges of equity interests in the subsidiaries of the Company.
The Credit Agreement contains customary covenants including, but not limited to, (i) a minimum interest coverage ratio and a maximum Consolidated Total Leverage Ratio and (ii) limitations on incurrence of debt, investments, liens on assets, certain sale and leaseback transactions, transactions with affiliates, mergers, consolidations and sales of assets. The Company was in compliance with all covenants as of
December 31, 2017
. The Credit Agreement also includes customary events of default, conditions, representations and warranties, and indemnification provisions.
As of
December 31, 2017
, we had
no
outstanding balance from draws on the Credit Facility and
$30.0 million
was available to be drawn upon. Concurrent with the execution of the above Credit Agreement, the Company terminated its previous revolving line of credit established on December 15, 2014. As of December 31, 2016 we had
no
outstanding balance from draws on the previous revolving line of credit and was in compliance with all covenants.
On February 13, 2013, we completed our IPO by issuing
4,666,667
shares of our Class A common stock, par value
$0.001
per share, at a price to the public of
$14.00
per share of Class A common stock. In addition, we issued
8,666,667
shares of our Class B common stock, of which
8,580,000
shares of Class B common stock were obtained by HPI and
86,667
shares of Class B common stock were obtained by HPIS, of which HPI is the managing member. In addition, we granted the underwriters of the IPO the right to purchase additional shares of Class A common stock to cover over-allotments (the “over-allotment option”).
Our authorized capital stock consists of
100,000,000
shares of Class A common stock, par value
$0.001
per share,
20,000,000
shares of Class B common stock, par value
$0.001
per share, and
5,000,000
shares of preferred stock, par value
$0.001
per share.
Class A Common Stock and Class B Common Stock
Each share of Class A common stock and Class B common stock entitles its holders to
one
vote per share on all matters to be voted upon by the stockholders, and holders of each class will vote together as a single class on all such matters. Holders of shares of our Class A common stock and Class B common stock vote together as a single class on all matters presented to our stockholders for their vote or approval, except as otherwise required by applicable law. As of
December 31, 2017
, the Class A common stockholders had
76.3%
of the voting power in HIIQ and the Class B common stockholders had
23.7%
of the voting power in HIIQ. Holders of shares of our Class A common stock have
100%
of the economic interest in HIIQ. Holders of Class B common stock do
no
t have an economic interest in HIIQ.
The determination to pay dividends, if any, to our Class A common stockholders will be made by our Board of Directors. We do not, however, expect to declare or pay any cash or other dividends in the foreseeable future on our Class A common stock, as we intend to reinvest any cash flow generated by operations in our business. We may enter into credit agreements or other borrowing arrangements in the future that prohibit or restrict our ability to declare or pay dividends on our Class A common stock. In the event of liquidation, dissolution or winding up of HIIQ, the holders of Class A common stock are entitled to share ratably
in all assets remaining after payment of liabilities, subject to prior distribution rights of preferred stock, if any, then outstanding. The holders of our Class A common stock have no preemptive or conversion rights or other subscription rights. There are no redemption or sinking fund provisions applicable to the Class A common stock. The rights, preferences and privileges of holders of our common stock will be subject to those of the holders of any shares of our preferred stock we may issue in the future.
Class B common stockholders will not be entitled to any dividend payments. In the event of any dissolution, liquidation, or winding up of our affairs, whether voluntary or involuntary, after payment of our debts and other liabilities and making provision for any holders of our preferred stock that have a liquidation preference, our Class B common stockholders will not be entitled to receive any of our assets. In the event of our merger or consolidation with or into another company in connection with which shares of Class A common stock and Class B common stock (together with the related membership interests) are converted into, or become exchangeable for, shares of stock, other securities or property (including cash), each Class B common stockholder will be entitled to receive the same number of shares of stock as is received by Class A common stockholders for each share of Class A common stock, and will not be entitled, for each share of Class B common stock, to receive other securities or property (including cash). No holders of Class B common stock will have preemptive rights to purchase additional shares of Class B common stock.
Exchange Agreement
On February 13, 2013, we entered into an exchange agreement (the “Exchange Agreement”) with the holders of the Series B Membership Interests of HPIH (“Series B Membership Interests”). Pursuant to and subject to the terms of the Exchange Agreement and the amended and restated limited liability company agreement of HPIH, holders of Series B Membership Interests, at any time and from time to time, may exchange one or more Series B Membership Interests, together with an equal number of shares of our Class B common stock, for shares of our Class A common stock on a one-for-one basis, subject to equitable adjustments for stock splits, stock dividends and reclassifications. In connection with each exchange, HPIH cancels the delivered Series B Membership Interests and issues to us Series A Membership Interests on a one-for-one basis. Thus, as holders exchange their Series B Membership Interests for Class A common stock, our interest in HPIH increases.
Holders will not have the right to exchange Series B Membership Interests if we determine that such exchange would be prohibited by law or regulation or would violate other agreements to which we may be subject. We may impose additional restrictions on exchanges that we determine necessary or advisable so that HPIH is not treated as a “publicly traded partnership” for U.S. federal income tax purposes. If the Internal Revenue Service were to contend successfully that HPIH should be treated as a “publicly traded partnership” for U.S. federal income tax purposes, HPIH would be treated as a corporation for U.S. federal income tax purposes and thus would be subject to entity-level tax on its taxable income.
In accordance with the Exchange Agreement, in March 2013, we received a net amount of
$1.4 million
in proceeds from the issuance of
100,000
shares of Class A common stock through the over-allotment option. We immediately used the proceeds to acquire Series B Membership Interests, together with an equal number of shares of our Class B common stock, from HPI. These Series B Membership Interests were immediately recapitalized into Series A Membership Interests in HPIH.
On February 1, 2014, a registration statement on Form S-3 became effective under which we registered
8,566,667
shares of our Class A common stock for resale from time to time by the selling stockholder, of which all such shares are issuable upon the exchange of an equivalent number of Series B Membership Interests (together with an equal number of shares of our Class B common stock).
On August 15, 2014, we entered into an underwriting agreement and exchange agreement with Raymond James & Associates, Inc., as the underwriter, and HPI and HPIS, as selling stockholders (the “Selling Stockholders”) to exchange Series B Membership Interests and an equal number of shares of our Class B common stock for
1,725,000
shares of Class A common stock to the Selling Stockholders. The Selling Stockholders agreed to immediately after the exchange sell to the underwriter for resale all
1,725,000
shares of Class A common stock at a public offering price of
$12.15
per share (
$11.54
per share, net of underwriting discounts), for net proceeds of
$19.9 million
. No shares were sold by the Company in this offering. The sale by the Selling Stockholders was made pursuant to a registration statement on Form S-3. At the time of exchange, the acquisition of the Series B Membership Interests resulted in a decrease in noncontrolling interests with an offsetting increase in stockholders’ equity to reflect the decrease in the noncontrolling interest’s investment in HPIH.
On March 13, 2017, the Selling Stockholders completed a secondary underwritten public offering of
3,000,000
shares of our Class A common stock under the above-described Form S-3 registration statement. In connection with the offering, on March 8, 2017, we entered into an underwriting agreement with Canaccord Genuity Inc., Cantor Fitzgerald & Co., Northland Securities, Inc., and Lake Street Capital Markets, LLC, collectively as the underwriters, and the Selling Stockholders. Immediately prior to the completion of the offering, we issued
3,000,000
shares of Class A common stock to the Selling Stockholders. In exchange for the issuance of the shares, we immediately acquired
3,000,000
Series B Membership Interests, together with an equal number of
shares of our Class B common stock from the Selling Stockholders. These Series B Membership Interests were immediately recapitalized into Series A Membership Interests in HPIH. The Selling Stockholders agreed to immediately after the exchange sell to the underwriter for resale all
3,000,000
shares of Class A common stock at a public offering price of
$14.00
per share (
$13.16
per share, net of underwriting discounts), for net proceeds of
$39.5 million
. No shares were sold by the Company in this offering. The acquisition of the Series B Membership Interests resulted in a decrease in noncontrolling interests with an offsetting increase in stockholders’ equity to reflect the decrease in the noncontrolling interest’s investment in HPIH. See Note 12 for further discussion of this transaction’s effects on a tax receivable agreement we previously entered into with holders of Series B Membership Interests.
Preferred Stock
Our board of directors has the authority to issue shares of preferred stock in one or more series and to fix the rights, preferences, privileges and restrictions thereof, including dividend rights, dividend rates, conversion rights, voting rights, terms of redemption, redemption prices, liquidation preferences and the number of shares constituting any series or the designation of such series, without further vote or action by the stockholders.
The issuance of preferred stock may have the effect of delaying, deferring or preventing a change in control of HIIQ without further action by the stockholders and may adversely affect the voting and other rights of the holders of Class A common stock. At present, we have no plans to issue any preferred stock.
Treasury Stock
Treasury stock is recorded at cost. As of
December 31, 2017
and
2016
, we held
380,777
and
119,544
shares of treasury stock, respectively, recorded at a cost of
$6.9 million
and
$1.1 million
, respectively.
Registration Statement on Form S-3
On May 5, 2017, the Company filed a registration statement on Form S-3, which was declared effective by the SEC on May 19, 2017, to offer and sell, from time to time, up to
$150.0 million
of any combination of debt securities, Class A Common Stock, preferred stock, warrants, subscription rights, units, or purchase contracts as described in the related prospectus. Securities may be sold in one or more classes or series and in amounts, at prices and on terms that we will determine at the times of the offerings and we may offer the securities independently or together in any combination for sale directly to purchasers or through underwriters, dealers or agents to be designated at a future date. We intend to use the net proceeds from the sale of the securities for general corporate purposes, including potentially expanding existing businesses, acquiring businesses and investing in other business opportunities. At
December 31, 2017
the Company had not sold any securities under this registration statement.
Share Repurchase Program
On October 13, 2017, the Company’s Board of Directors authorized a share repurchase program for up to
$50.0 million
of the Company’s outstanding Class A Common Stock. The share repurchase authorization permits the Company to periodically repurchase shares for cash for a period of
24
months in open market purchases, block transactions and privately negotiated transactions in accordance with applicable federal securities laws. The actual timing, number and value of shares repurchased under the program will be determined by the Company’s management at its discretion and will depend on a number of factors, including the market price of the Company’s common stock, general market and economic conditions, regulatory requirements, capital availability and compliance with the terms of the Company’s credit facility. Repurchases under the program will be funded from one or a combination of existing cash balances, future free cash flow, and indebtedness. There is no guarantee as to the number of shares that will be repurchased, and the repurchase program may be extended, suspended or discontinued at any time without notice at the Company’s discretion.
Under the stock repurchase program, the Company may elect to adopt a Rule 10b5-1 share repurchase plan under the Securities Exchange Act of 1934, as amended (a “10b5-1 Plan”). A 10b5-1 Pan, if adopted, would allow the Company to repurchase its shares at times when it otherwise might be prevented from doing so under insider trading laws or because of self-imposed trading blackout periods. Because repurchases under a 10b5-1 Plan, if one is adopted, are expected to be subject to certain pricing parameters, there is no guarantee as to the exact number of shares that would be repurchased under a 10b5-1 Plan.
During the year ended
December 31, 2017
, we repurchased
222,184
shares of our registered Class A common stock under our Repurchase Plan at an average price per share of $
22.15
. During the year ended
December 31, 2016
, there were
no
repurchases made under the previously authorized plan established on December 17, 2014. The previous plan remained in place until
December 31, 2016
.
Tax Obligation Settlements and Treasury Stock Transactions
Treasury stock is recorded pursuant to the surrender of shares by certain employees to satisfy statutory tax withholding obligations on vested restricted stock awards. In addition, certain forfeited stock based awards are transferred to and recorded as treasury stock, and certain restricted stock awards have been granted from shares in Treasury, and certain forfeited awards.
During the year ended
December 31, 2017
, there were
39,049
shares transferred to Treasury as a result of surrendered shares of vested stock awards for the settlement of participant tax obligations. During the year ended
December 31, 2016
, there were
21,397
shares transferred to Treasury as a result of surrendered shares of vested restricted stock awards for participant tax obligations. During the year ended
December 31, 2016
, there were
43,600
shares transferred to Treasury as the result of forfeitures of restricted stock awards, and
75,749
shares were granted to certain employees from Treasury as restricted stock awards. See Note 8 for further information on our Long Term Incentive Plan.
|
|
8.
|
Stock-based Compensation
|
We maintain one stock-based incentive plan, the Health Insurance Innovations, Inc. Long Term Incentive Plan (the “LTIP”), which became effective February 7, 2013, under which SARs, restricted stock, restricted stock units and other types of equity and cash incentive awards may be granted to employees, non-employee directors and service providers. The LTIP expires after
ten
years, unless prior to that date the maximum number of shares available for issuance under the plan has been issued or our Board of Directors terminates this plan. At its inception,
1,250,000
shares of Class A common stock were reserved for issuance under the LTIP. In May
2017
, the Company’s shareholders approved an increase of
2,000,000
shares of Class A common stock and as of that date to
December 31, 2017
, there were
5,250,000
shares of Class A common stock reserved for issuance under the LTIP. As of
December 31, 2016
, there were
3,250,000
shares of Class A common stock reserved for issuance under the LTIP. At December 31, 2017, there were approximately
1.1 million
remaining shares available for grant under the LTIP.
Restricted Stock
The vesting periods for grant recipients are at the discretion of the Compensation Committee of our Board of Directors and may be vested upon grant, in whole, or in part, but generally vest over a
three
or
four
year period. Restricted stock awards are amortized using the accelerated method over the vesting period.
The table below summarizes activity regarding unvested restricted stock under the LTIP during the years ended
December 31, 2017
and
2016
(all amounts in thousands, except per share data):
|
|
|
|
|
|
|
|
|
Number of Shares Outstanding
|
|
Weighted-Average Grant Date Fair Value (per share)
|
Restricted stock unvested at January 1, 2016
|
201
|
|
|
$
|
7.50
|
|
Granted
|
284
|
|
|
$
|
8.93
|
|
Vested
|
(56
|
)
|
|
$
|
7.39
|
|
Forfeited
|
(43
|
)
|
|
$
|
7.90
|
|
Restricted stock unvested at December 31, 2016
|
386
|
|
|
$
|
8.52
|
|
Granted
|
880
|
|
|
$
|
22.02
|
|
Vested
|
(139
|
)
|
|
$
|
8.68
|
|
Forfeited
|
(3
|
)
|
|
$
|
21.95
|
|
Restricted stock unvested at December 31, 2017
|
1,124
|
|
|
$
|
19.04
|
|
We realized income tax benefits of
$437,000
and
$57,000
from activity involving restricted shares for the years ended
December 31, 2017
and
2016
, respectively. The total grant date fair value of restricted stock that vested for the years ended
December 31, 2017
and
2016
was
$1.2 million
and
$413,000
, respectively.
Stock Appreciation Rights
The SARs activity for the years ended
December 31, 2017
and
2016
is as follows (all amounts in thousands, except per share data):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
SARs
|
|
Weighted-Average Exercise Price
|
|
Weighted-Average Remaining Contractual Term (in years)
|
|
Aggregate Intrinsic Value (a)
|
Outstanding at January 1, 2016
|
1,422
|
|
|
$
|
6.40
|
|
|
5.6
|
|
|
$
|
2,238
|
|
Granted
|
909
|
|
|
$
|
7.34
|
|
|
—
|
|
|
$
|
—
|
|
Exercised (b)(c)
|
(35
|
)
|
|
$
|
5.85
|
|
|
—
|
|
|
$
|
253
|
|
Forfeited or expired
|
(67
|
)
|
|
$
|
4.95
|
|
|
—
|
|
|
$
|
26
|
|
Outstanding at December 31, 2016
|
2,229
|
|
|
$
|
6.80
|
|
|
5.0
|
|
|
$
|
24,640
|
|
Granted
|
251
|
|
|
$
|
26.16
|
|
|
—
|
|
|
$
|
—
|
|
Exercised (b)(c)
|
(1,412
|
)
|
|
$
|
5.56
|
|
|
—
|
|
|
$
|
21,524
|
|
Forfeited or expired
|
(20
|
)
|
|
$
|
11.17
|
|
|
—
|
|
|
$
|
112
|
|
Outstanding at December 31, 2017
|
1,048
|
|
|
$
|
13.02
|
|
|
5.2
|
|
|
$
|
13,104
|
|
Exercisable at December 31, 2017
|
399
|
|
|
$
|
10.39
|
|
|
3.8
|
|
|
$
|
5,803
|
|
|
|
(a)
|
The intrinsic value of a SAR is the amount by which the market value of the underlying stock as of
December 31, 2017
, and
2016
exceeds the exercise price of the option multiplied by the number of shares represented by such SAR.
|
|
|
(b)
|
Shares issued upon the exercise of SARs are treated as newly issued shares. There were
1,028,767
shares issued during
2017
related to exercises of SARs. There were
14,489
shares issued during
2016
related to exercises of SARs.
|
|
|
(c)
|
There was a
$3.8 million
tax benefit recognized in
2017
related to the adoption of ASU 2016-09 in the first quarter of 2017. There was
no
tax benefit recognized in
2016
related to stock-based compensation for SARs.
|
During the year ended
December 31, 2017
, the weighted-average grant date fair value per share of stock-based compensation granted to employees during the period was
$14.08
per share. The total fair value of SARs that vested for the year ended
December 31, 2017
was
$1.1 million
.
During the year ended
December 31, 2016
, the weighted-average grant date fair value per share of stock-based compensation granted to employees during the period was
$3.68
per share. The total fair value of SARs that vested for the year ended
December 31, 2016
was
$3.1 million
.
On February 9, 2017, the Company’s former Chief Executive Officer exercised
1.0 million
SARs at the then NASDAQ Global Market close price of
$19.75
resulting in the issuance of
753,197
shares of the Company’s Class A common stock. The transaction resulted in a
9.2%
increase in total issued Class A common stock from the December 31, 2016 reported balance.
Stock Options
The stock option activity for the years ended
December 31, 2017
and
2016
is as follows (all amounts in thousands, except per share data):
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Stock options
|
|
Weighted-Average Exercise Price
|
|
Weighted-Average Remaining Contractual Term (in years)
|
|
Aggregate Intrinsic Value (a)
|
Outstanding at January 1, 2016
|
79
|
|
|
$
|
1.07
|
|
|
7.3
|
|
|
$
|
442
|
|
Granted
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
—
|
|
Exercised (b)(c)
|
(39
|
)
|
|
$
|
1.06
|
|
|
—
|
|
|
$
|
330
|
|
Forfeited or expired
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
—
|
|
Outstanding at December 31, 2016
|
40
|
|
|
$
|
1.08
|
|
|
6.5
|
|
|
$
|
668
|
|
Granted
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
—
|
|
Exercised (b)(c)
|
(30
|
)
|
|
$
|
1.08
|
|
|
—
|
|
|
$
|
694
|
|
Forfeited or expired
|
—
|
|
|
$
|
—
|
|
|
—
|
|
|
$
|
—
|
|
Outstanding at December 31, 2017
|
10
|
|
|
$
|
1.09
|
|
|
5.5
|
|
|
$
|
223
|
|
Exercisable at December 31, 2017
|
9
|
|
|
$
|
1.09
|
|
|
5.5
|
|
|
$
|
209
|
|
|
|
(a)
|
The intrinsic value of a stock option is the amount by which the market value of the underlying stock as of
December 31, 2017
, and
2016
, exceeds the exercise price of the option multiplied by the number of shares represented by such stock option.
|
|
|
(b)
|
Shares issued upon the exercise of stock options are treated as newly issued shares. There were
30,498
shares issued during
2017
related to exercises of stock options. There were
35,606
shares issued during
2016
related to exercises of stock options.
|
|
|
(c)
|
There was
no
tax benefit recognized in
2017
or
2016
related to stock-based compensation for stock options.
|
During the year ended
December 31, 2017
and
2016
,
no
stock options were granted. The total fair value of stock options that vested for the years ended
December 31, 2017
and
2016
was
$92,000
and
$269,000
, respectively.
Accounting for Stock-Based Compensation
Expense for stock-based compensation is recognized based upon estimated grant date fair value and is amortized over the requisite service period of the awards using the accelerated method. We offer awards which vest based on service conditions, performance conditions, or market conditions. For grants of SARs and stock options, we apply the Black-Scholes option-pricing model, a Monte Carlo Simulation, or a lattice model, depending on the vesting conditions, in determining the fair value of share-based payments to employees. These models incorporate various assumptions, including expected volatility and expected term. Through November of 2015, expected stock price volatilities were estimated using implied volatilities of comparable publicly-traded companies, given our limited trading history. Since December 2016, volatility has been calculated using the Company’s trading history. The expected term of the awards represents the estimated period of time until exercise, giving consideration to the contractual terms, vesting schedules and expectations of future employee behavior. The Company uses its best estimate and the simplified method for “plain vanilla” awards under GAAP for calculating the expected term, where applicable. The risk-free interest rate is based on the U.S. Treasury yield curve in effect at the time of grant with an equivalent remaining term. Compensation expense is recognized only for those awards expected to vest, with forfeitures estimated based on our historical experience and future expectations. In accordance with GAAP, compensation expense is not recognized for awards with performance vesting conditions until it is deemed probable that the underlying performance events will occur. All stock-based compensation expense is classified within SG&A expense in the consolidated statements of income.
During the first quarter of 2017, the Company elected to early adopt ASU 2016-09, Compensation-Stock Compensation (Topic 718): Improvements to Employee Share-Based Payment Accounting, and as a result of this adoption, excess tax benefits of
$4.2 million
related to vested and exercised share-based compensation awards were recorded as a decrease in income tax expense
in the consolidated statement of income. The Company has elected to continue its policy of estimating forfeitures in accordance with the update.
None
of the stock-based compensation was capitalized during the years ended
December 31, 2017
or
2016
.
The Black-Scholes option-pricing model was used with the following weighted average assumptions for the years ended
December 31, 2017
and
2016
:
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Risk-free rate
|
1.8
|
%
|
|
1.4
|
%
|
Expected life
|
4.7 years
|
|
|
4.9 years
|
|
Expected volatility
|
64.8
|
%
|
|
58.7
|
%
|
Expected dividend
|
none
|
|
|
none
|
|
The following table summarizes stock-based compensation expense for the years ended
December 31, 2017
and
2016
($ in thousands):
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Restricted shares
|
$
|
5,760
|
|
|
$
|
517
|
|
SARs
|
1,628
|
|
|
3,174
|
|
Stock options
|
16
|
|
|
101
|
|
|
$
|
7,404
|
|
|
$
|
3,792
|
|
The following table summarizes unrecognized stock-based compensation and the remaining period over which such stock-based compensation is expected to be recognized as of
December 31, 2017
and
2016
($ in thousands):
|
|
|
|
|
|
|
|
2017:
|
|
Unrecognized
Expense
|
|
Weighted Average
Remaining years
|
Restricted shares
|
|
$
|
12,978
|
|
|
2.1
|
SARs
|
|
3,037
|
|
|
2.1
|
|
|
$
|
16,015
|
|
|
|
2016:
|
|
|
|
|
|
Restricted shares
|
|
$
|
2,086
|
|
|
2.1
|
SARs
|
|
1,492
|
|
|
2.0
|
Stock options
|
|
13
|
|
|
0.6
|
|
|
$
|
3,591
|
|
|
|
These amounts do not include the cost of any additional awards that may be granted in future periods nor any changes in our forfeiture rate.
We are the sole managing member of HPIH. HPIH is treated as a partnership for U.S. federal, and most applicable state and local income tax purposes. As a partnership, HPIH is not subject to entity-level federal or state income taxation. Any taxable income or loss generated by HPIH is passed through to, and included in, the taxable income or loss of its members, including us, on a pro rata basis. We are subject to U.S. federal, state and local income taxes on our allocable share of net taxable income or loss of HPIH, as well as any stand-alone income or loss generated by HIIQ. HIIQ’s subsidiary HP is subject to U.S. federal, state and local income taxes separately from HIIQ due to the ownership structure.
The provision for income tax for the years ended
December 31, 2017
and
2016
, consisted of the following components ($ in thousands):
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Current:
|
|
|
|
|
|
Federal
|
$
|
2,473
|
|
|
$
|
3,295
|
|
State
|
385
|
|
|
493
|
|
Total current taxes
|
2,858
|
|
|
3,788
|
|
Deferred:
|
|
|
|
|
|
Federal
|
13,264
|
|
|
(7,736
|
)
|
State
|
696
|
|
|
(803
|
)
|
Total deferred taxes
|
13,960
|
|
|
(8,539
|
)
|
Income taxes
|
$
|
16,818
|
|
|
$
|
(4,751
|
)
|
For the year ended
December 31, 2017
the provision for income taxes was
$16.8 million
. For the year ended December 31, 2016 the benefit for income taxes was
$4.8 million
. Deferred taxes on our investment in HPIH are measured on the difference between the carrying amount of our investment in HPIH and the corresponding tax basis of this investment. We do not measure deferred taxes on differences within HPIH, as those differences inherently comprise our deferred taxes on our external investment in HPIH.
The items accounting for differences between the federal statutory income tax rate and our effective tax rate for the years ended
December 31, 2017
and
2016
, are as follows:
|
|
|
|
|
|
|
|
2017
|
|
2016
|
U.S. federal income tax rate
|
35.0
|
%
|
|
35.0
|
%
|
State income taxes, net of federal tax benefits
|
3.1
|
%
|
|
(0.1
|
)%
|
Tax Act
|
18.7
|
%
|
|
—
|
%
|
Valuation allowance
|
(10.6
|
)%
|
|
(51.6
|
)%
|
Operations of nontaxable subsidiary
|
(8.0
|
)%
|
|
(40.9
|
)%
|
Stock-based compensation contribution
|
—
|
%
|
|
(1.2
|
)%
|
Non-deductible or non-taxable items
|
0.1
|
%
|
|
2.0
|
%
|
Other
|
0.5
|
%
|
|
—
|
%
|
Total
|
38.8
|
%
|
|
(56.8
|
)%
|
The effective tax rate for the year ended
December 31, 2017
was
38.8%
and the effective tax rate for the year ended
December 31, 2016
was
(56.8)%
. The difference was mainly driven by the Tax Act, the change in the valuation allowance on the investment in HPIH that is deemed permanent in nature, and the non-controlling interest income. HP’s 2017 book loss generates a deferred tax benefit which is offset by a valuation allowance. On a standalone basis, the effective tax rate for the year ended December 31, 2017 for HIIQ and HP was
33.4%
and
0.0%
, respectively.
The deferred income tax assets consisted of the following as of
December 31, 2017
and
2016
($ in thousands):
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Deferred tax assets:
|
|
|
|
|
|
Investment in subsidiary
|
$
|
17,980
|
|
|
$
|
16,715
|
|
Tax receivable agreement
|
3,991
|
|
|
3,789
|
|
Stock compensation
|
694
|
|
|
694
|
|
Net operating loss carryforwards
|
3,165
|
|
|
2,230
|
|
Allowance for doubtful accounts
|
5
|
|
|
4
|
|
Other
|
2
|
|
|
165
|
|
Total deferred tax assets
|
25,837
|
|
|
23,597
|
|
Less valuation allowances
|
(9,250
|
)
|
|
(12,799
|
)
|
Deferred tax assets, net of valuation allowance
|
16,587
|
|
|
10,798
|
|
Deferred tax liabilities:
|
|
|
|
|
|
Identifiable intangible assets
|
(1,197
|
)
|
|
(2,383
|
)
|
Stock compensation
|
(423
|
)
|
|
(225
|
)
|
Other
|
(7
|
)
|
|
(9
|
)
|
Deferred tax assets, net
|
$
|
14,960
|
|
|
$
|
8,181
|
|
As of
December 31, 2017
, the Company had net deferred tax assets totaling approximately
$15.0 million
. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled.
At
December 31, 2017
and
2016
, HIIQ had
no
federal or state net operating loss carryforwards. Additionally, at
December 31, 2017
and
2016
, HP had approximately
$14.0 million
and
$5.7 million
, respectively, of federal and state net operating loss carryforwards. These carryforwards are generally available through 2037 and start expiring in 2033.
As of December 31, 2017, the Company determined that a valuation allowance of
$9.3 million
was necessary to reduce the HPIH outside basis deferred tax asset that is permanent in nature by
$7.0 million
and HP’s deferred tax assets by
$2.3 million
. We evaluate quarterly the positive and negative evidence regarding the expected realization of net deferred tax assets. The carrying value of our net deferred tax assets is based on our assessment as to whether it is more likely than not that we will generate sufficient future taxable income to realize these deferred tax assets. We had recorded a valuation allowance against all of the deferred tax assets of HIIQ and maintained a full valuation allowance on all of these deferred tax assets until December 31, 2016. When we determined that we would be able to realize our remaining deferred income tax assets in the foreseeable future, a release of the related valuation allowance resulted in the recognition of
$8.1 million
of deferred tax assets at December 31, 2016. Significant management judgment is required in determining the period in which the reversal of a valuation allowance should occur.
The Tax Act
On December 22, 2017, prior to the end of the Company’s fiscal year, the President of the United States signed into law H.R. 1, referred to as the “Tax Act.” The Securities and Exchange Commission (“SEC”) issued Staff Accounting Bulletin No. 118 (“SAB 118”) on December 22, 2017. SAB 118 provides up to a one-year measurement period from a registrant’s reporting period that includes the Tax Act’s enactment date to allow the registrant sufficient time to obtain, prepare and analyze information to complete the accounting required under ASC 740.
The reduction of the U.S. federal tax rate from 35% to 21% resulted in tax expense of
$12.6 million
due to the re-measurement of our deferred tax assets. The reduction of the federal tax rate also resulted in a one-time increase to income of
$11.8 million
due to the reduction of the TRA liability. The overall net impact of these amounts reduced earnings by
$775,000
. The reduction in the tax rate will also impact the company’s tax expense in future periods beginning in 2018.
The Company is evaluating the other provisions of the Act and does not believe that the other provisions will have a material impact on the consolidated financial statements, if any.
Uncertain Tax Positions
We account for uncertainty in income taxes using a two-step process. The first step is to evaluate the tax position for recognition by determining if the weight of available evidence indicates that it is more likely than not that the position will be sustained upon audit, including resolution of related appeals or litigation processes, if any. The second step requires us to estimate and measure the tax benefit as the largest amount that is more than 50% likely to be realized upon ultimate settlement. Such amounts are subjective, as a determination must be made on the probability of various possible outcomes. We reevaluate uncertain tax positions on a quarterly basis. This evaluation is based on factors including, but not limited to, changes in facts or circumstances, changes in tax law, effectively settled issues under audit and new audit activity. Such a change in recognition and measurement could result in recognition of a tax benefit or an additional tax provision.
As of
December 31, 2017
and
2016
, respectively, we did
no
t have a balance of gross unrecognized tax benefits, and as such, no amount would favorably affect the effective income tax rate in any future periods. The Company accounts for interest and penalties associated with uncertain tax positions as a component of tax expense, and none were included in the Company’s financial statements as there are no uncertain tax positions outstanding as of
December 31, 2017
and
2016
, respectively. The Company’s 2013 through 2016 tax years remain subject to examination by tax authorities.
The computations of basic and diluted net income per share attributable to HIIQ for the years ended
December 31, 2017
and
2016
were as follows ($ in thousands, except share and per share data):
|
|
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Basic net income attributable to Health Insurance Innovations, Inc.
|
$
|
17,885
|
|
|
$
|
4,513
|
|
Weighted average shares—basic
|
10,970,995
|
|
|
7,599,533
|
|
Effect of dilutive securities:
|
|
|
|
|
Restricted shares
|
340,141
|
|
|
89,126
|
|
SARs
|
606,029
|
|
|
176,801
|
|
Stock options
|
20,560
|
|
|
43,775
|
|
Weighted average shares—diluted
|
11,937,725
|
|
|
7,909,235
|
|
Basic net income per share attributable to Health Insurance Innovations, Inc.
|
$
|
1.63
|
|
|
$
|
0.59
|
|
Diluted net income per share attributable to Health Insurance Innovations, Inc.
|
$
|
1.50
|
|
|
$
|
0.57
|
|
Potential common shares are included in the diluted net loss per share calculation when dilutive. Potential common shares consist of Class A common stock issuable through restricted stock grants, stock options, and SARs and are calculated using the treasury stock method.
The following securities were not included in the calculation of diluted net income per share for the respective periods because such inclusion would be anti-dilutive (in thousands):
|
|
|
|
|
|
|
|
Year Ended December 31,
|
|
2017
|
|
2016
|
Restricted shares
|
860
|
|
|
284
|
|
SARs
|
251
|
|
|
1,179
|
|
Stock options
|
—
|
|
|
—
|
|
Additionally, potential common stock totaling
3,841,667
shares at
December 31, 2017
and
6,841,667
shares at
December 31, 2016
issuable under an exchange agreement were not included in diluted shares because such inclusion would be antidilutive. See Note 12 for further details on the exchange agreement.
Operating segments are defined as components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker (“CODM”), or decision-making group, in deciding how to allocate resources and in assessing performance. Our President and Chief Executive Officer is our named CODM. The CODM reviews our financial information in a manner substantially similar to the accompanying consolidated financial statements. As such, at
December 31, 2017
and
2016
, we had
one
reportable operating and geographic segment. The Company periodically reviews the structure of our organization and CODM communications to assess the continued appropriateness of our segment reporting.
|
|
12.
|
Commitments and Contingencies
|
Leases
We lease office space to conduct our operations which expire between
2017
and
2019
. The office space operating lease agreements contain rent holidays and rent escalation provisions. Rent holidays and rent escalation provisions are considered in determining straight-line rent expense to be recorded over the lease term. The difference between cash rent payments and straight-line rent expense was
$15,000
and
$34,000
as of
December 31, 2017
and
2016
, respectively. Total rent expense under all operating leases, which includes equipment, was
$618,000
and
$504,000
for the years ended
December 31, 2017
and
2016
, respectively, and is included in SG&A expenses in the accompanying consolidated statements of income.
As of
December 31, 2017
, the future minimum lease payments under noncancellable operating leases were as follows ($ in thousands):
|
|
|
|
|
2018
|
$
|
569
|
|
2019
|
371
|
|
2020
|
—
|
|
2021
|
—
|
|
2022
|
—
|
|
Total minimum lease payments
|
$
|
940
|
|
BimSym Agreements
On August 1, 2012, the Company entered into a software assignment agreement with BimSym eBusiness Solutions, Inc. (“BimSym”) for our exclusive ownership of all rights, title and interest in the technology platform (“A.R.I.E.S. System”) developed by BimSym and utilized by us. As a result of the agreement, we purchased the A.R.I.E.S. System, our proprietary sales and member administration platforms, for
$45,000
and this purchase was capitalized and recorded as an intangible asset. In connection with this agreement, we simultaneously entered into a master services agreement for the technology, under which we are required to make monthly payments of
$26,000
for
five
years. After the
five
-year term, this agreement automatically renews for
one
-year terms unless we give
60
days’ notice. As of August 1, 2017, the Company had fulfilled its commitment under the agreement and had not provided notice of cancellation to BimSym thereby automatically renewing the agreement for an additional one-year term.
Additionally, on August 1, 2012, the Company also entered into an exclusivity agreement with BimSym whereby neither BimSym nor any of its affiliates would create, market or sell a software, system or service with the same or similar functionality as that of A.R.I.E.S. System under which we were required to make monthly payments of
$16,000
for
five years
. The present value of these payments was capitalized and recorded as an intangible asset with a corresponding liability on the accompanying consolidated balance sheets. As of August 1, 2017, both parties to the agreement had fulfilled their commitment.
Tax Receivable Agreement
On February 13, 2013, we entered into a TRA with the holders of the HPIH Series B Membership Interests, which holders are beneficially owned by Michael W. Kosloske, our founder and Chief of Product Innovation. The TRA requires us to pay to such holders
85%
of the cash savings, if any, in U.S. federal, state and local income tax we realize (or are deemed to realize in the case of an early termination payment, a change in control or a material breach by us of our obligations under the TRA) as a result of any possible future increases in tax basis and of certain other tax benefits related to entering into the TRA, including tax benefits attributable to payments under the TRA itself. This is HIIQ’s obligation and not an obligation of HPIH. HIIQ will benefit from the remaining
15%
of any realized cash savings. For purposes of the TRA, cash savings in income tax is computed by comparing our actual income tax liability with our hypothetical liability had we not been able to utilize the tax benefits subject to the TRA
itself. The TRA became effective upon completion of the IPO and will remain in effect until all such tax benefits have been used or expired, unless HIIQ exercises its right to terminate the TRA for an amount based on the agreed payments remaining to be made under the agreement or HIIQ breaches any of its material obligations under the TRA in which case all obligations will generally be accelerated and due as if HIIQ had exercised its right to terminate the agreement. Any potential future payments will be calculated using the market value of our Class A common stock at the time of the relevant exchange and prevailing tax rates in future years and will be dependent on us generating sufficient future taxable income to realize the benefit. Payments are generally due under TRA within a specified period of time following the filing of our tax return for the taxable year with respect to which payment of the obligation arises.
Exchanges of Series B Membership Interests, together with an equal number of shares of our Class B common stock, for shares of our Class A common stock, are expected to increase our tax basis in our share of HPIH’s tangible and intangible assets. These increases in tax basis are expected to increase our depreciation and amortization deductions and create other tax benefits and therefore may reduce the amount of tax that we would otherwise be required to pay in the future. As of
December 31, 2017
, Series B Membership Interests, together with an equal number of shares of Class B common stock have been exchanged for a total of
4,825,000
shares of Class A common stock subsequent to the IPO. See Note 7 for further information on these issuances of Class A common stock.
As a result of the exchanges noted above, we have recorded a liability of
$16.2 million
pursuant to the TRA as of
December 31, 2017
. The TRA liability was significantly impacted by the Tax Act which resulted in an
$11.8 million
decrease in the liability as a result of revaluing the related deferred tax asset at the lower enacted corporate tax rates expected to be in effect at time of realization. We have determined that this TRA amount is probable of being paid based on our estimates of future taxable income. This liability represents the share of tax benefits payable to the entities beneficially owned by Mr. Kosloske, if we generate sufficient taxable income in the future. As of December 31, 2016, management reversed the deferred tax asset valuation allowance relating to the TRA. This decision was based on historical earnings, and the outlook of future earnings. The exchange transactions created a tax benefit to be shared by the Company and the entities beneficially owned by Mr. Kosloske.
As of
December 31, 2017
, we have made
$1.2 million
of cumulative payments under the TRA. See Note 9 for further information on the income tax implications of the TRA.
Legal Proceedings
The Company is subject to legal proceedings, claims, and liabilities that arise in the ordinary course of business. The Company accrues losses associated with legal claims when such losses are probable and reasonably estimable. If the Company determines that a loss is probable and cannot estimate a specific amount for that loss, but can estimate a range of loss, the best estimate within the range is accrued. If no amount within the range is a better estimate than any other, the minimum amount of the range is accrued. Estimates are adjusted as additional information becomes available or circumstances change. Legal defense costs associated with loss contingencies are expensed in the period incurred.
State Regulatory Examinations
Indiana Multistate Market Conduct Examination
The Company received notification in April 2016 from the Indiana Department of Insurance that a multistate examination had been commenced providing for the review of HCC Life Insurance Company’s (“HCC”) short-term medical plans, Affordable Care Act compliance, marketing, and rate and form filing for all products. In May 2016, the Company received notice that the Market Actions Working Group of the National Association of Insurance Commissioners determined that the examination would become a multistate examination of the Company, which included forty-three (43) states. As the Company was a program manager of HCC products at that time, the notification indicated that the multistate examination would include a review of the activities of the Company and a review of whether the Company’s practices are in compliance with Indiana insurance law and the similar laws of other states participating in the examination. The Company received additional requests on March 16, 2017 in the form of an Expanded Warrant “subpoena” expanding the scope and time period of the examination to include a review of the Company’s marketing, sales, and administration of insurance products for all parties with whom the Company conducted business. The Company has provided the information requested by the expanded warrant. On February 1, 2018, revised February 8, 2018, a letter request was provided to the Company requesting the same information covered by the previously issued warrant, but for carriers other than HCC, for a limited number of categories of previously requested information. The Company is currently providing the information sought in the letter request. The Company is now and has been cooperating fully with the examiners. To date, there have been no reported findings of any sort, no breaches and specifically, no findings of wrong doing against the Company. In addition to the multistate examination led by Indiana, we are aware that several other states, including Florida and
South Dakota are reviewing the sales practices and potential unlicensed sale of insurance by independently owned and operated third-party licensed-agent call centers utilized by the Company.
The Company is aware of and managing additional claims and inquiries in other states that, except for the inquiries described below, the Company does not believe are material at this time. Except as otherwise described below, it is too early to determine whether any of these regulatory examinations will have a material impact on the Company. The Company is proactively communicating and cooperating with all applicable regulatory agencies, and has provided a detailed action plan to regulators that summarizes the Company’s enhanced compliance and control mechanisms.
Montana Regulatory Action
In May 2016, the Company received notification from the Office of the Montana State Auditor, Commissioner of Securities and Insurance (“CSI”) that an administrative action had been initiated against it. On October 31, 2017, the Company was dismissed from the action. As a result, the Company’s exposure related to this matter, if any, is solely tied to Montana’s involvement in the multistate examination.
Massachusetts Regulatory Action
The Company received notification of a civil investigative demand from the Massachusetts Attorney General’s Office (“MAG”) on June 16, 2016. The MAG has requested certain information and documents from the Company which will be used to review the Company’s sales and marketing practices to ensure the Company is in compliance with Massachusetts laws and regulations. Additionally, the Company’s materials and sales and marketing practices are being evaluated in order to ensure that they are neither deceptive nor do they constitute unfair trade practices.
The Company continues to provide all requested documents and materials requested by the MAG. The Company continues to cooperate with the MAG in the interest of bringing the matter to an agreeable conclusion. While the MAG has indicated it is amenable to exploring all available options, it is still too early to assess whether the MAG’s investigation will result in a material impact on the Company. The Company believes that based on the nature of the allegations raised by the MAG, a loss arising from the future assessment of a civil penalty against the Company is probable. Notwithstanding, due to the relatively procedural stage of the investigative process, the settlement of another party (a carrier) for the same set of allegations, and the fact that the Company has neither requested nor received evidentiary material from the MAG, the Company is currently unable to estimate the amount of any potential civil penalty or determine a range of potential loss under the MAG’s investigation of the Company. It is possible there may be no financial loss, a nominal or minimal loss, or some other mutually satisfactory resolution reached with the MAG in connection with the MAG’s investigation of the Company.
Texas Regulatory Action
In September 2016, the Texas Department of Insurance (“TDI”) notified the Company that it has instituted an enforcement action to investigate alleged violations of advertising rules and third-party administrator license requirements in connection with the sale of the Company’s products. In connection with the investigation, the TDI requested certain information, records, and explanations, to which the Company responded. On February 8, 2018, the TDI notified the Company that it had closed the investigation effective February 2, 2018. The TDI verbally indicated that the inquiry has been coded as an “internal inquiry and review that resulted in a finding of ‘no violation’ with no disciplinary action taken.” The matter is considered resolved without penalty or fine from the TDI.
We are proactively communicating and cooperating with all regulatory agencies involved in the above-described examinations and actions and we have recently developed and enhanced our compliance and control mechanisms. However, it is too early to determine whether any of these regulatory matters will have a material impact on our business (except Texas, as described above). Any adverse finding could result in significant penalties or other liabilities and/or a requirement to modify our marketing or business practices and the practices of our third-party independent distributors, which could harm our business, results of operations or financial condition. Moreover, an adverse regulatory action in one jurisdiction could result in penalties and adversely affect our license status or reputation in other jurisdictions due to the requirement that adverse regulatory actions in one jurisdiction be reported to other jurisdictions.
Claims that involve independently licensed third-party insurance agencies and their agents, and independent insurance carriers, in which the Company is named as a co-defendant
The Company has received claims from insureds relating to lack of carrier coverage, claims handling, and alleged deceptive sales practices relating to independent insurance carriers. In some situations, those claims also include third-party independent sales agencies with allegations relating to deceptive sales practices. In each of these individual insureds’ claims, the Company attempts to dismiss, challenge or resolve the claims as quickly as possible. Recently, in the
Azad, et al. v. Tokio Marine HCC, et al.
, Case No. Case 3:17-cv-00618, U.S. District Court for the Northern District of California, (“Azad case”), the Company received a non-certified class action complaint alleging that an independent third-party agent and the independent insurance carrier misrepresented the type and availability of coverage and also was deficient in claims intake, handling, processing and payouts. The Company was named as an additional defendant in the case. The federal court dismissed the Company ruling that the alleged violations were issues for the independent agent and carrier to address, and not correctly pled against the Company. The Azad case dismissal on September 22, 2017 was with prejudice so the Company was relieved of liability in that regard. The Company independently filed its own lawsuit against that same carrier, HCC, seeking that the Court ascertain and declare the rights and obligations between the parties. That declaratory action was filed in Hillsborough County, Florida and is styled as
Health Insurance Innovations, Inc., et al. v. HCC Medical Insurance Services, LLC, et al.
, Case No. 17-CA-6679. This declaratory action was filed in response to indemnity demands that the Company received from HCC. No lawsuit has been filed against the Company by HCC, and on August 18, 2017, HCC sent a letter to the Company limiting the scope of its indemnification demand to the Montana administrative matter discussed above (that the Company has been dismissed from), the multistate review discussed above, and the Azad case. Following the Company’s dismissal from the Azad case, on September 29, 2017 HCC sent an additional letter to the Company further limiting the scope of its indemnification demand by removing the Azad case.
In January 2018, the Company was named as a defendant in a non-certified class action complaint styled as
Aliquo, et al. v. HCC Medical Insurance Services, LLC, et al
., Case No. 18-cv-18, U. S. District Court for the Southern District of Indiana ("Aliquo case"). While the matter is still in its earliest stages of being evaluated, similar to other cases involving the conduct of independent insurance carriers and independent sales agencies, the allegations revolve largely around the conduct of independent insurance carriers related to the claims handling, processing, and resolution process, though the complaint also alleges that potentially deceptive sales practices and unfair trade practices or misrepresentations may also have occurred. The Aliquo case, which largely attempts to bring claims under the RICO Act, seeks to link the Company’s marketing efforts to the independent carriers’ conduct of alleged improper claims handling, post-claims underwriting, and denials despite the Company being uninvolved in either the claims-handling aspect of the process. An additional claim for breach of contract is alleged solely against the independent insurance carriers. Similar to the Azad case described above, the Company will continue to assert that it doesn’t engage in post- claims underwriting or claims handling as complained of in the case. While it is possible that a loss may arise from this case, the amount of such loss is not known or estimable at this time.
Similarly, in the
Sean McMaster and Kim McMaster v. Companion Life Ins. Co., et al.
, Case No. CV2017-006414, Superior Court for the State of Arizona in the County of Maricopa, there are allegations of denied and deficient claims handling relating to another insurance carrier in which the Company was also named as a defendant. The Company is asserting defenses against the claims not limited to that it doesn’t adjudicate claims and made no misrepresentations to McMaster. While it is possible that a loss may arise from this case, the amount of such loss is not known or estimable at this time.
Similar again, is the
Charles M. Butler, III and Chole Butler v. Unified Life Ins. Co., et al.
, Case No. 17-cv-00050-SPW-TJC, U.S. District Court for the District of Montana (Billings Div.) (“Butler case”), in which allegations of misrepresentation and claims handling were made against the independent insurance agency and a carrier, and the plaintiff also named the Company as a party. The Butler case is in the procedural stage of discovery and motion practice. The Company is asserting defenses against the claims not limited to that it doesn’t adjudicate claims and made no misrepresentations to Butler. While it is possible that a loss may arise from this case, the amount of such loss is not known or estimable at this time.
Other
Purported Securities Class Action Lawsuits
In September 2017, three putative securities class action lawsuits were filed against the Company and certain of its current and former executive officers. The cases are styled
Cioe Investments Inc. v. Health Insurance Innovations, Inc., Gavin Southwell, and Michael Hershberger
, Case No. 1:17-cv-05316-NG-ST, filed in the U.S. District Court for the Eastern District of New York on September 11, 2017;
Michael Vigorito v. Health Insurance Innovations, Inc., Gavin Southwell, and Michael Hershberger
, Case No. 1:17-cv-06962, filed in the U.S. District Court for the Southern District of New York on September 13, 2017; and
Shilpi Kavra v. Health Insurance Innovations, Inc., Patrick McNamee, Gavin Southwell, and Michael Hershberger
, Case No. 8:17-cv-02186-EAK-MAP, filed in the U.S. District Court for the Middle District of Florida on September 21, 2017. All three of the foregoing actions (the “Securities Actions”) were filed after a decline in the trading price of the Company’s common stock following the release of a report authored by a short-seller of the Company’s common stock raising questions about, among other things, the Company’s public disclosures relating to the Company’s regulatory examinations and regulatory compliance. All three of the Securities Actions, which are based substantially on the allegations raised in the short-seller report, contain substantially the same allegations and allege that the Company made materially false or misleading statements or omissions relating to regulatory compliance matters, particularly regarding to the Company’s application for a third-party administrator license in the State of Florida. The Securities Actions allege violations of Section 10(b) of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), SEC Rule 10b-5, and Section 20(a) of the Exchange Act. According to the filed complaints, the p
laintiffs in the Securities Actions are seeking an undetermined amount of damages, interest, attorneys’ fees and costs on behalf of putative classes of individuals and entities that acquired shares of the Company’s common stock on periods ending September 11, 2017. The
Cioe Investments
and
Vigorito
cases have been transferred to the U.S. District Court for the Middle District of Florida, and on December 28, 2017, they were consolidated with the
Kavra
matter under the case caption,
In re Health Insurance Innovations Securities Litigation
, Case No. 8:17-cv-2186-EAK-MAP (M.D. Fla.). On February 6, 2018, the court appointed a lead plaintiff and lead counsel and ordered that lead plaintiff shall file and serve a consolidated complaint no later than 45 days after the order, that is, by March 23, 2018. The Company intends to vigorously defend against the claims. It is possible that similar lawsuits may yet be filed in the same or other courts that name the same or additional defendants.
TPA Licensure
On February 14, 2018, the OIR executed a consent order granting a Certificate of Authority to conduct business as a third-party insurance administrator in the State of Florida to HPIH. The consent order and Certificate of Authority were granted pursuant to an application submitted to the OIR by HPIH in October 2017. In the consent order, which sets forth terms and conditions associated with the license, the OIR assessed a fine of
$140,000
as a result of a finding by the OIR (which HPIH did not contest) that HPIH conducted business as an insurance administrator in the State of Florida prior to HPIH’s submission of the application.
Telephone Consumer Protection Act
The Company has received a number of private-party claims relating to alleged violations of the federal Telephone Consumer Protection Act ("TCPA") by its independently owned and operated licensed-agent distributors, alleging that their marketing activities were potentially unlawful. Additionally, the Company has been named as a defendant in multiple lawsuits relating to alleged TCPA matters, including claims styled, but not yet certified, as class actions. There are three primary cases filed in the courts by Plaintiffs Craig Cunningham, Kenneth Moser, and Amandra Hicks, each styled as a class action but not yet certified, and each Plaintiff alleging or seeking damages ranging from
$160,000
to over
$5,000,000
. The Company is defending these claims and has filed motions to dismiss or the equivalent in each matter. On February 13, 2018, the Company successfully obtained a dismissal from the Cunningham case. The Company is presently reviewing the remaining matters and reviewing distributor compliance, and enhancing existing compliance. While these types of claims have previously settled, been dismissed, or resolved without any material effect on the Company, there is a possibility in the future that one or more could have a material effect. While it is possible that a loss may arise from these cases, the amount of such loss is not known or estimable at this time. The Company requires that its independently owned and operated licensed-agent distributors reimburse or indemnify it for any such settlements.
Data and Privacy
The Company has previously received inquiries but no claims, litigation, or findings of violation relating to alleged data loss and/or privacy breaches relating to affiliated companies. Each allegation is investigated upon receipt and handled promptly to resolution.
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13.
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Employee Benefit Plan
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We sponsor a benefit plan to provide retirement benefits for our employees, known as the Health Plan Int Holdings LLC 401(k) Profit Sharing Plan & Trust (the “Plan”). Participants may make voluntary contributions to the Plan from their annual base pre-tax compensation, cash bonuses, and commissions in an amount not to exceed the federally determined maximum allowable contribution amounts. For each of the years ended
December 31, 2017
, and
2016
, the base maximum allowable contribution amount was
$18,000
. The Plan also permits for discretionary Company contributions. For each of the years ended
December 31, 2017
and
2016
, the Company accrued
$56,000
for discretionary matching contributions to participants.
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14.
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Related-Party Transaction
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Health Plan Intermediaries, LLC
HPI and its subsidiary HPIS, which are beneficially owned by Mr. Kosloske, are related parties by virtue of their Series B Membership interests in HPIH, of which we are managing member. During the years ended
December 31, 2017
, and
2016
, HPIH paid cash distributions of
5.5 million
and
$2.0 million
, respectively, to these entities related to estimated federal and state income taxes, pursuant to the operating agreement entered into by HPIH and HPI. At
December 31, 2017
, the Company has accrued
$638,000
in distributions owed but not yet paid under the operating agreement. The distribution made during the year ended
December 31, 2017
included
$2.8 million
that was accrued as of
December 31, 2016
.
Distributions by HPIH to its members
Pursuant to the operating agreement of HPIH, we determine when distributions will be made to the members of HPIH and the amount of any such distributions, except that HPIH is required by the operating agreement to make certain pro rata distributions to each member of HPIH quarterly on the basis of the assumed tax liabilities of the members.
Members of HPIH, including HIIQ, incur U.S. federal and state income taxes on their allocable share of any net taxable income of HPIH. Net profits and net losses of HPIH are generally allocated to its members pro rata in accordance with the percentage interest of the units they hold. In accordance with the operating agreement of HPIH, we cause HPIH to make cash distributions to its members for purposes of funding their tax obligations in respect of the income of HPIH that is allocated to them. Generally, these tax distributions are computed based on our estimate of the net taxable income of HPIH allocable to the member multiplied by an assumed tax rate equal to the highest marginal effective federal, state and local income tax rate applicable for an individual or corporation taking into account any allowable deductions. Additional amounts may be distributed to us if needed to meet our tax obligations and our obligations pursuant to the TRA. As of
December 31, 2017
, there were
$638,000
of distributions to its members declared but unpaid and reported in due to member on the consolidated balance sheet.
Tax Receivable Agreement
As discussed in Note 12, on February 13, 2013, we entered into a tax receivable agreement with the holders of HPIH Series B Membership Interests, which are beneficially owned by Mr. Kosloske.
As of
December 31, 2017
, re-measurement of the TRA liability as a result of the Tax Act reduced our obligation by
$11.8 million
. We are obligated to pay
$16.2 million
pursuant to the TRA, of which
$1.1 million
was included in current liabilities and
$15.1 million
was included in long-term liabilities on the accompanying consolidated balance sheet. As of
December 31, 2017
, we have made cumulative payments under the TRA of
$1.2 million
. As of
December 31, 2016
, there was
$10.0 million
payable pursuant to the TRA, of which
$521,000
was included in current liabilities and
$9.5 million
was included in long-term liabilities on the accompanying consolidated balance sheets.
Reinsurance
Insurance carriers with which we do business often reinsure a portion of their risk. From time to time, entities owned or affiliated with Michael Kosloske, serve as reinsurers for insurance carriers that offer products sold by HPIH.
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15.
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Concentrations of Credit Risk and Significant Customers
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Accounts receivable, net were
$2.9 million
and
$882,000
as of
December 31, 2017
and
2016
, respectively and is included as a component of accounts receivable, net, prepaid expenses, and other current assets in the accompanying consolidated balance sheets. As of
December 31, 2017
we had two customers who made up approximately
26%
of the net accounts receivable balance. As of
December 31, 2016
we had two customers who made up approximately
43%
of the accounts receivable, net balance.
Advanced commissions were
$39.5 million
and
$37.0 million
as of
December 31, 2017
, and
2016
, respectively. For the year ended
December 31, 2017
, two distributors accounted for
60%
of our advanced commissions balance compared to the two distributors who accounted for
81%
for the year ended
December 31, 2016
.
Revenues primarily consist of commissions and fees earned for health insurance policies and supplemental products issued to members, referral fees, and fees for discount benefit plans paid by members as a direct result of our enrollment services, brokerage services or referral sales. No members individually accounted for
10%
or more of the Company’s revenue for the years ended
December 31, 2017
or
2016
.
For the year ended
December 31, 2017
, three carriers accounted for
54%
of our premium equivalents and for the year ended
December 31, 2016
, three carriers accounted for
60%
of our premium equivalents. For the year ended
December 31, 2017
, Federal Insurance Company ("CHUBB") accounted for
26%
, Everest Reinsurance Company accounted for
17%
, and Companion Life Insurance Company accounted for
11%
, of our premium equivalents. The Company anticipates that its premium equivalents in
2018
will continue to be concentrated among a small number of carriers, although as a part of the Company’s strategy of improving and increasing its product mix by seeking to add innovative new products, the Company anticipates that its carrier concentration may decrease.
The Company maintains its cash and cash equivalents at various financial institutions where we are insured by the Federal Deposit Insurance Corporation up to
$250,000
. The balances of these accounts from time to time exceed federally insured limits. The Company has not experienced any losses in such accounts. The Company believes it is not exposed to any significant credit risk on cash and cash equivalents.
HEALTH INSURANCE INNOVATIONS, INC.
EXHIBIT INDEX
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Exhibit No.
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Description
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1.1
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Underwriting Agreement, dated March 8, 2017 among Canaccord Genuity, Inc., Cantor Fitzgerald & Co., Health Insurance Innovations, Inc., Health Plan Intermediaries, LLC, and Health Plan Intermediaries Sub, LLC. Incorporated herein by reference to Exhibit 1.1 to the Company’s Form 8-K filed on March 8, 2017.
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2.1
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Agreement and Plan of Merger, dated July 14, 2014, among Health Insurance Innovations, Inc. SV Merger Sub, Inc., HealthPocket, Inc. Bruce Telkemp, Sheldon Wang, any Holder executing a Letter of Transmittal, Option Cancellation Agreement or Parent Option Agreement, and Randy Herman, as the Representative (all disclosure schedules to the Agreement and Plan of Merger have been omitted pursuant to Item 601(b)(2) of Regulation S-K). Incorporated by reference to Exhibit 2.1 to Current Report on Form 8-K filed July 16, 2014.
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3.1
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3.2
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3.3
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4.1
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4.2
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10.1
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10.2
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10.3
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10.4
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10.5#
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Exhibit No.
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Description
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10.6#
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10.7
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10.8
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10.9
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10.10#
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10.11#
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10.12#
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10.13#
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10.14#
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10.15#
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10.16#
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10.17#
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10.18#
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10.19#
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10.20#
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Exhibit No.
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Description
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10.21#
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10.22#
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10.23#
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10.24#
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10.25#
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10.26#
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10.27#
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10.28#
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10.29#
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10.30#
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10.31#
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10.32
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10.33
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10.34*
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21*
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23*
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Exhibit No.
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Description
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31.1*
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31.2*
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32*
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100.INS
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XBRL Instance Document.
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101.SCH
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XBRL Taxonomy Extension Schema Document.
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101.CAL
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XBRL Taxonomy Calculation Linkbase Document.
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101.LAB
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XBRL Taxonomy Label Linkbase Document.
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101.PRE
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XBRL Taxonomy Presentation Linkbase Document.
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101.DEF
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XBRL Taxonomy Definition Document.
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*
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Document is filed with this Form 10-K.
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#
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Indicates a management contract or compensatory plan or arrangement contemplated by Item 15(a)(3) of Form 10-K.
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SIGNATURES
Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.
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HEALTH INSURANCE INNOVATIONS, INC.
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By:
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/s/ Gavin D. Southwell
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Gavin D. Southwell
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President and Chief Executive Officer
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(Principal Executive Officer)
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March 1, 2018
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Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on behalf of the Registrant and in the capacities and on the dates indicated.
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DATE
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SIGNATURE
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TITLE
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March 1, 2018
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/s/ Gavin D. Southwell
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President, Chief Executive Officer and Director
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Gavin D. Southwell
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(Principal Executive Officer)
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March 1, 2018
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/s/ Michael D. Hershberger
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Chief Financial Officer, Secretary and Treasurer
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Michael D. Hershberger
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(Principal Financial and Accounting Officer)
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March 1, 2018
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/s/ Michael W. Kosloske
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Director and Chief of Product Innovation
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Michael W. Kosloske
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March 1, 2018
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/s/ Paul G. Gabos
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Director
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Paul G. Gabos
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March 1, 2018
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/s/ Robert S. Murley
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Director
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Robert S. Murley
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March 1, 2018
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/s/ Paul E. Avery
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Director
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Paul E. Avery
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March 1, 2018
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/s/ Anthony J. Barkett
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Director
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Anthony J. Barkett
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March 1, 2018
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/s/ John A. Fichthorn
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Director
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John A. Fichthorn
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March 1, 2018
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/s/ Dr. Sheldon Wang
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Director
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Dr. Sheldon Wang
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